Raj Chovatiya, MD, PhD: Evaluating Roflumilast Foam’s Inclusivity in Diverse Hair Types

Earlier this month, Arcutis Biotherapeutics announced that an expert panel of dermatologists from across the US met and confirmed that roflumilast foam 0.3% (Zoryve), used for the treatment of seborrheic dermatitis, does not contain harmful ingredients such as thickening agents, alcohol, fragrances, essential oils, or oxidizing agents. Overall, 8 out of the 9 panel experts expressed feeling “extremely confident” about using roflumilast foam with patients of diverse skin and hair types, including individuals with previous hair treatments.¹

The outcomes of the panel discussion of roflumilast foam supported the publication of a follow-up study in the Journal of Clinical and Aesthetic Dermatology, “Putting the Formulation Back in Foam: Optimizing Seborrheic Dermatitis Treatment Across Diverse Hair Types.” Chovatiya et al conducted a comprehensive assessment of beauty industry standards to better understand roflumilast foam’s inclusivity in diverse hair types.²

The study authors focused their analysis on ingredient categories cautioned against by the beauty industry due to their potential to negatively affect hair and skin health, including sulfates such as sodium lauryl sulfate and sodium laureth sulfate that can cause hair dryness. In their assessment, Chovatiya et al also evaluated dyes, preservatives, thickening agents, fragrances, citrus and essential oils, alcohols, oxidizing agents, and retinoids that can have adverse effects.²

To further discuss the significance of the expert panel and published study on roflumilast foam used in diverse hair types, Dermatology Times spoke to first author, Raj Chovatiya, MD, PhD, clinical associate professor at the Rosalind Franklin University Chicago Medical School, founder and director of the Center for Medical Dermatology and Immunology Research, and Dermatology Times’ Fall 2024 Editor in Chief.

Transcript

Raj Chovatiya, MD, PhD: Hi there, my name is Dr. Raj Chovatiya, clinical associate professor at the Rosalind Franklin University Chicago Medical School and founder and director of the Center for Medical Dermatology and Immunology research in Chicago, Illinois.

Dermatology Times: Can you please provide an overview of the expert panel and published study that examined roflumilast foam for seborrheic dermatitis across diverse hair types?

Chovatiya: Very recently, there was an expert panel put together at a large dermatology conference of individuals across the span of clinical research and everything in between dermatology who had an expertise in thinking about formulation and the use of topical products. And it was based on the result of this meeting that we recently published a manuscript talking a little bit about the approach to treating seborrheic dermatitis, and the views of the formulation for topical roflumilast foam. I myself was not a member of said panel, but as someone who has been working in the seborrheic dermatitis disease space for quite a while, I had the pleasure of being able to parse through a lot of the data that came together from the meeting to really understand what clinicians thought when thinking about seborrheic dermatitis, what were some of the needs, specifically, and then what topical roflumilast foam could potentially offer individual as really the first targeted treatment in this space in essentially forever.

Dermatology Times: As a dermatologist who treats numerous diverse patient populations, why was this specific review of roflumilast foam's inclusivity important to you?

Chovatiya: Seborrheic dermatitis is a complicated condition to treat, we sometimes think that it's quite straightforward, but when you consider the different areas of the skin that are involved, a lot of hair-bearing surfaces, particularly on the head and neck, and especially the scalp, you realize it's not so straightforward. Our conventional topicals whether they be ointment, gel, solution, or shampoo, all have certain limitations when thinking about use, either it’s too greasy, not pliable, too thick, very messy, extremely drying, a lot of irritants. And so, individuals really need something that can fit in their own personal hygiene habits. And that's another really big part of this too, is even if you have the perfect product, is it something that someone can use every day, every few days, or only every few weeks in conjunction with their normal haircare approach. And so it was really important to explore how a topical foam product, one that has a very different formulation than other foams that have come before it, can really fill in the gap for every different kind of patient no matter how frequently they wash their hair, no matter what other products they use concurrently, and no matter where on the body they will be applying said product.

Dermatology Times: How can other dermatology clinicians use this data to counsel and guide their patients through seborrheic dermatitis treatment?

Chovatiya: Well, I think the first thing is really considering the individual needs of your patient and understanding that not everybody is going to have a one-size-fits-all approach to therapy, meaning that just recommending someone to shampoo every day and use a solution twice a day as a reflexive essentially recommendation, is probably not going to be the best choice for everyone. And I'm not here to advocate saying that there is one product you should use over another but rather, think critically about what your patient is looking for, what their normal approach is to their own routine habits, how often they wash their hair, what is their hair type? What type of products are they typically used to using and then use that in conjunction with your own understanding of what can be able to really match the right product for the right patient.

Dermatology Times: Roflumilast foam was just approved at the end of last year. How are patients able to access this medication through specific programs or insurance to ensure they can obtain the treatment they need?

Chovatiya: Since the launch of roflumilast foam, it's been a really fun time in the seborrheic dermatitis world because we really have not had a targeted therapy like this that can be used across body sites across different individuals, and one that most importantly, is really designed to be thinking with the patient in mind when thinking about diverse hair types and here quality. And so, since its inception as a topical product in the US, we know that there can definitely be challenges when thinking about branded topical medications. But through a combination of essential using central pharmacy that's helpful by the company itself, the program the company has specifically for helping individuals to get access in case they have certain challenges related to their life circumstances, their insurance, and overall availability through a wide variety of specialty pharmacies. I think most of us will agree that it's actually been pretty smooth sailing to connect our patients to foam medication. And the reason I emphasize that is historically we all have a knee-jerk trigger reaction. If it's a foam, it must be something super expensive, difficult to get very, very complicated, not going to waste time with it. But I think this is a circumstance where you have a foam-based product in the case of roflumilast foam that is relatively straightforward to get as one of the only targeted treatments we have for seborrheic dermatitis in this regard, and one that really is flexible across the different places patients might be using it. So overall it's been very positive for me.

[Transcript lightly edited for space and clarity.]

References

1. Expert panel review further validates use of ZORYVE (roflumilast) topical foam, 0.3% for treatment of seborrheic dermatitis across diverse hair types published in Journal of Clinical and Aesthetic Dermatology. News release. Arcutis Biotherapeutics. May 13, 2024. Accessed May 29, 2024. https://www.arcutis.com/expert-panel-review-further-validates-use-of-zoryve-roflumilast-topical-foam-0-3-for-treatment-of-seborrheic-dermatitis-across-diverse-hair-types-published-in-journal-of-clinical-and-aestheti/
2. Chovatiya R, Polaskey MT, Lain E, et al. Putting the formulation back in foam: optimizing seborrheic dermatitis treatment across diverse hair types. J Clin Aesthet Dermatol. 2024;17(5):30-33.