Aguh is an associate professor of dermatology and the director of the Ethnic Skin Program at the Johns Hopkins School of Medicine.

Crystal Aguh, MD, FAAD

Skin of Color Savvy: The Art and Science of Treating Patients of Color

Skin of Color Savvy: Highlights From the Most-Watched Episodes of 2025

, the podcast revisits highlights from the three most viewed episodes of 2025, bringing together expert insights on inflammatory skin disease, pigmentary disorders, and diversity in dermatologic research. Featuring conversations with 

 leaders, Andrew Alexis, MD, MPH; Shawn Kwatra, MD; Crystal Aguh, MD; John Harris, MD, PhD; Nada Elbuluk, MD; and Michelle Rodrigues, MBBS, the episode underscores the breadth of clinical, scientific, and equity-focused discussions that resonated most with audiences throughout the year.

The episode opens with a return to one of the show’s most impactful early conversations, in which Alexis and Kwatra discuss diseases that disproportionately affect patients with skin of color, particularly chronic pruritus and inflammatory conditions such as atopic dermatitis and prurigo nodularis. Kwatra reflects on the disconnect between textbook imagery and real-world clinical presentations, noting that many diagnostic criteria and educational resources remain centered on lighter skin types.

Together, they explore emerging data demonstrating racial and ethnic differences in itch prevalence and presentation, while highlighting how environmental exposures, socioeconomic factors, and systemic inflammation intersect to influence disease burden. Alexis builds on this discussion by emphasizing the importance of recognizing how erythema and inflammation present differently in richly pigmented skin. Rather than classic redness, inflammation may appear violaceous, gray, or brown, a distinction that is critical to avoiding underdiagnosis and undertreatment.

The second segment revisits a widely viewed episode focused on pigmentary disorders, featuring Elbuluk and Rodrigues. The pair emphasize that “hyperpigmentation” is not a diagnosis, but a broad category encompassing more than 45 distinct conditions. They discuss common causes of hyperpigmentation, hypopigmentation, and depigmentation seen in patients of color, including post-inflammatory hyperpigmentation, acquired dermal macular hyperpigmentation, melasma, vitiligo, and less common congenital or medication-induced disorders. Key diagnostic principles—such as evaluating lesion location, color, morphology, and patient history—are highlighted, along with the value of dermoscopy as a noninvasive bedside tool to guide management and avoid unnecessary biopsies.

The episode concludes with highlights from a conversation featuring Aguh and Harris, which centers on the importance of diversity in dermatology research and clinical trials. Using examples from alopecia and autoimmune disease research, the discussion expands the definition of diversity beyond race and ethnicity to include diversity of thought, training background, and scientific perspective. Both speakers emphasize that collaborative, multidisciplinary research leads to stronger study design, fewer blind spots, and more clinically meaningful outcomes for patients.

Together, this Savvy Stories episode captures why these three conversations stood out among viewers in 2025. By blending clinical insight, scientific rigor, and a commitment to equity, the episode reflects Skin of Color Savvy’s mission to elevate dermatologic care through education, representation, and inclusive dialogue.

To learn more about SOCS’s programs and initiatives, visit 

Editor’s note: This summary was edited with the help of AI tools.

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This new episode from January 2026 features a compilation of 3 clips from the most viewed episodes of 2025.

Skin of Color Savvy: The Science of Curly Hair, With Crystal Aguh, MD, and Loren Krueger, MD

, dermatologists Crystal Aguh, MD, and Loren Krueger, MD, explored the biological, cultural, and clinical considerations behind curly and coily hair patterns. This podcast by 

, features a discussion underscoring the ways in which textured hair care represents a critical—and often overlooked—component of dermatologic expertise.

Curly hair is inherently more fragile than straight hair, with structural features that make it prone to dryness, breakage, and inflammation-related disease. According to Aguh, this fragility parallels the challenges of dry skin: without proper moisture retention and care, minor issues can progress into medical disease. For dermatologists, understanding textured hair is therefore not elective—it is essential to preventing conditions such as traction alopecia, acquired trichorrhexis nodosa, and central centrifugal cicatricial alopecia (CCCA).

Krueger emphasized that nearly every form of alopecia—from androgenetic to autoimmune variants—can present in patients with curly hair, but diagnostic precision requires recognizing when styling practices contribute to disease. She noted that effective management involves more than identifying pathology; it requires guiding patients toward healthier styling behaviors while respecting their cultural identities and lifestyle constraints.

For clinicians unfamiliar with curly hair care, Aguh recommended starting with the basics—what she calls a “soak and smear” method for the hair, analogous to the technique used for eczema management. Patients should be advised to cleanse weekly with a non-drying shampoo, condition regularly, and seal in moisture with a leave-in product, oil, or emollient. These steps help reinforce the hair cuticle and prevent cumulative damage that predisposes to breakage.

The conversation also addressed styling practices frequently described as “protective,” such as braids, twists, and sew-in weaves. Both dermatologists noted that these should instead be viewed as “styles of convenience”—useful in moderation but potentially harmful if worn too tightly or for extended periods. Appropriate guidance includes limiting braided styles to six to eight weeks, avoiding back-to-back installations, and recognizing that tightness and scalp pain are early indicators of follicular injury.

Age-related hair fragility and chemical exposure further complicate outcomes. Patients accustomed to long-standing styling routines often underestimate how aging, coloring, or relaxing can weaken the hair over time. Dermatologists must therefore distinguish between true hair loss and breakage-related thinning to prevent unnecessary laboratory testing or scalp biopsies.

Ultimately, the “science of curls” reflects the intersection of biology, identity, and daily care. By integrating practical knowledge of hair texture into routine dermatologic evaluation, clinicians can enhance outcomes, foster trust, and deliver more culturally responsive care for all patients.

To learn more about SOCS’s mentorship programs and initiatives, visit 

This October 16 Skin of Color Savvy highlights the often overlooked topic of curly hair in dermatology.

Skin of Color Savvy: Diversity in Dermatology Within the Modern Landscape, with Crystal Aguh, MD, and John Harris, MD, PhD

, Crystal Aguh, MD, associate professor of dermatology and director of the Ethnic Skin Program at the Johns Hopkins School of Medicine, and John Harris, MD, the founding Director of the Vitiligo Clinic and Research Center, founding director of the Autoimmune Therapeutics Institute and professor and chair of the Department of Dermatology at UMass Chan Medical School in Worcester, together explored the importance of mentorship, visibility, and leadership among dermatologists and dermatology trainees of different backgrounds.

Hosted by Skin of Color Society (SOCS) leaders, this podcast episode continues to delve into the latest research, clinical insights, and culturally intelligent and responsive care practices in the field of dermatology. Together, Aguh and Harris spoke on a variety of subjects in this area.

Aguh and Harris discussed the importance of diversity in clinical trials and research, emphasizing the need for diverse principal investigators and teams. Harris highlighted his experiences moderating a panel on incorporating diversity into clinical research, noting the challenges and benefits. They discussed the impact of federal regulations on National Institutes of Health (NIH) grants and the necessity of addressing questions about the importance of diversity.

Harris pointed out the challenges of addressing conversations regarding diversity among clinicians and in clinical research within the present political climate, highlighting that some have questioned whether to bring up the conversation at all. Both expressed optimism about the growth and impact of SOCS in advancing research and treatment for patients of color.

As the episode closed, the conversation reinforced the power of mentorship, the importance of role models, and the responsibility of current leaders to cultivate a more equitable future in dermatology. For both those in medical school and those who are current health care providers, the episode offers a compelling look at how connection, advocacy, and shared purpose can drive lasting change within the specialty.

Editor's note: This interview was summarized with the aid of artificial intelligence.

This episode of the SOCS podcast features an in-depth discussion between Crystal Aguh, MD, and John Harris, MD, PhD.

2025 American Academy of Dermatology (AAD) Annual Meeting

 suggest improved glycemic control could help patients with 

central centrifugal cicatricial alopecia (CCCA)

A retrospective cohort study led by a team from Johns Hopkins School of Medicine, results of the study demonstrate those maintaining an HbA1c level less than 5.7% were 5 times more likely to experience improvement in scalp fibrosis as their counterparts with an HBA1c in the diabetes or prediabetes range.

“I think as dermatologists, we are used to our specialty overlapping with other specialties such as rheumatology, infectious disease, but I think one specialty we need to take a closer look at is endocrinology,” explained lead investigator Crystal Aguh, MD, an associate professor of dermatology and the director of the Ethnic Skin Program at the Johns Hopkins School of Medicine, in an interview with HCPLive. “A lot of our skin diseases actually are impacted by insulin resistance and diabetes, and I'm hopeful that moving forward, this will be a bigger emphasis within our field.”

A retrospective cohort study of patients treated at Johns Hopkins Hospital between June 2022 and June 2024, the analysis aimed to better illustrate the relationship between elevated HbA1c levels and clinical symptoms of CCCA. During this time period, 81 patients received care and were deemed eligible for inclusion in the current study.

Participants were evaluated for scalp pruritus, pain, inflammation, and fibrosis. Elevated HbA1C was defined as 5.7% or greater, which is the recognized American Diabetes Association threshold for prediabetes. For the purpose of analysis, scalp fibrosis was assessed based on resistance during intralesional steroid treatment, ranging from none to significant resistance, occasionally causing needle bending or dulling.

In multivariable-adjusted analyses, controlling for age, diabetes medication, and BMI, results indicated elevated HbA1c was significantly associated with scalp fibrosis (Odds Ratio, 5.67; 95% CI, 1.40 to 22.95; 

 = .02), with no significant associations found for pruritus, pain, or inflammation.

To learn more about this study and the growing evidence base surrounding associations between glycemic control and dermatological conditions, check out our interview with Aguh during the Skin of Color Society’s Scientific Symposium.

Glycemic Control Influences Outcomes in Central Cicatricial Alopecia, with Crystal Aguh, MD

Relevant disclosures for Aguh include Eli Lilly and Company, Myovant Sciences, and Pfizer.

 Elevated Hemoglobin A1C Levels Associated with Increased Scalp Resistance in Central Centrifugal Cicatricial Alopecia

. Presented at the 2025 American Academy of Dermatology (ADA) Annual Meeting. Orlando, FL. March 07-11, 2025.

Crystal Aguh, MD, discusses a study from AAD 2025 examining HbA1c levels and outcomes in CCCA. 

Crystal Aguh, MD, FAAD

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