The Future of Dermatology

Episode 131: HS Updates, Prior Auth Reform & CA Legislation in Dermatology ft. Dr. Haley Naik | The Future of Dermatology Podcast

Summary:
In this episode of the Future of Dermatology podcast, host Dr. Faranak Kamangar sits down with Dr. Haley Naik, board-certified dermatologist, professor at UCSF, and Stanford and Harvard-trained expert, for a timely and eye-opening conversation on two major fronts: the rapidly evolving treatment landscape for Hidradenitis Suppurativa (HS) and the critical California state legislation that could reshape how dermatologists practice and how patients access care.
Dr. Naik opens with exciting updates in the HS space, including the three currently FDA-approved therapies and two promising agents anticipated to cross the finish line by 2027. She also shares a major advocacy win: HS has been designated a highlighted research topic by the NIH across three institutes, opening a one-year funding window starting April 7, 2026 that researchers should act on now.
The conversation then dives deep into the broken prior authorization system, with striking data points: 25% of dermatology visits require prior auth, 75% of denial letters have no listed decision maker, and the average dermatology practice spends $40,000 per year staffing for prior authorizations. Against this backdrop, Dr. Naik breaks down three California bills - two to support and one to oppose - that directly affect how dermatologists can care for their patients.
Whether you're a dermatologist, researcher, or patient advocate, this episode is packed with actionable information, from NIH grant deadlines to how to contact your state representative before late June voting deadlines.
Learn more and take action:AB539 (prior authorization reform): https://legiscan.com/CA/bill/AB539/2025SB895 (California Science and Health Research Bond Act): https://lnkd.in/gTjXXxtUFind your California representative to advocate for these bills: https://findyourrep.legislature.ca.gov/Information about the May 4th Rally for California Science: https://www.fundcascience.org/rally
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⚠️ This podcast is for educational purposes only and does not constitute medical advice. Always consult your healthcare provider.
Key Takeaways:
1. Three FDA-Approved HS Therapies Now Available Adalimumab, Secukinumab, and Bimzelx (bimekizumab) are currently FDA-approved for Hidradenitis Suppurativa, giving clinicians meaningful treatment options that didn't exist before 2015.2. Two More HS Therapies Expected by 2027 Povorcitinib (a JAK1 inhibitor by Incyte) and an IL-17A/F nanobody by Moonlake Therapeutics are both anticipated to receive approval in the coming years, with over 50 therapies currently in the HS pipeline.3. NIH Has Designated HS a Highlighted Funding Topic - Act Before April 2027 HS has been named a highlighted research topic across three NIH institutes. This designation runs from April 7, 2026 through April 2027. Researchers interested in HS funding must submit applications within this one-year window.4. The Prior Authorization System Is Widely Acknowledged as Broken Even the Blue Shield CEO publicly admitted the prior auth process is broken. The insurance industry issued a voluntary streamlining pledge in summer 2025. Key pain points include: step therapy requirements, peer-to-peer reviews often conducted by non-physicians, no identified decision maker on 75% of denial letters, and reauthorization periods as short as three months.5. AB 539 Would Extend Prior Auth Approvals to One Full Year Currently, prior authorizations for some medications last as little as three months, forcing practices to repeatedly restart the paperwork process and creating dangerous gaps in patient care. AB 539 would require approved prior authorizations to be maintained for one year (or the full treatment course if shorter). This is especially impactful for HS patients who already face a 7–10 year diagnostic delay.6. AB 2000 Would Ban Mid-Year Formulary Changes If a patient is doing well on a medication, insurers could currently remove that drug from formulary mid-year, forcing patients back through step therapy and increasing out-of-pocket costs. AB 2000 would prohibit these mid-year changes, protecting both patient stability and physician treatment decisions.7. SB 1094 Would Expand Pharmacist Biosimilar Substitution Authority - and Is Opposed Under current California law, pharmacists can only substitute a biologic with an FDA-designated "interchangeable" biosimilar, which requires extensive switching data. SB 1094 would allow substitution with any biosimilar, potentially without physician notification. The California Medical Association (CMA) opposes this bill due to patient safety concerns, as it removes clinical oversight from a complex medication decision.8. How to Take Action Before Late June Voting Deadlines California ballots are going out now. Dermatologists and patients can: (1) vote on these specific bills, and (2) call their state assembly member or representative to share their clinical perspective on AB 539, AB 2000, and SB 1094.9. Advocacy Drives Real Change in Dermatology The NIH highlighting of HS as a funded research priority is a direct result of years of advocacy by patients and physicians through the Hidradenitis Suppurativa Foundation. Dr. Naik emphasizes that dermatologists engaging in policy and advocacy can achieve meaningful systems-level change for their patients and their practices.10. Chronic Skin Disease Has a Broader Societal Impact Than Often Recognized Beyond the clinical burden, conditions like HS, psoriasis, and atopic dermatitis significantly affect patients' ability to work, participate in the economy, and maintain quality of life. Making this case to insurance reviewers, policymakers, and the public is part of effective dermatology advocacy.
Chapters:
00:00 – Welcome & Introduction to Dr. Haley Naik01:26 – HS Treatment Landscape: FDA-Approved Therapies & Pipeline Drugs03:40 – NIH Research Funding for HS: A One-Year Window Starting April 202605:08 – Why the Prior Authorization System Is Broken10:07 – AB 539: Extending Prior Auth Approvals to One Year16:58 – AB 2000: Banning Mid-Year Formulary Changes19:51 – SB 1094: Pharmacist Biosimilar Substitution & Why CMA Opposes It23:25 – How to Take Action & Voting Deadlines24:14 – What's Next: The Future of HS & Dermatology Advocacy

Episode 130: Agentic AI Workflows Explained | The Future of Dermatology Podcast

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Summary:
Fresh off her two talks at the AAD Annual Meeting in Denver, Dr. Faranak Kamangar, Inc. 2026 Female Founders 500, shares her reflections and the buzz from the conference floor. In this episode - part two of her AAD AI series - she dives deep into agentic AI workflows: what they are, why they matter for dermatology, and how they can realistically transform the day-to-day burden of clinical practice.
Dr. Kamangar unpacks the history of physician-led digitization that made healthcare AI possible, explores the evolution from simple chatbots to true agentic systems, and walks through concrete use cases, from prior authorizations and scheduling to AI scribes, patient education, and social media management. She also breaks down a green/yellow/red light framework for knowing which workflows are safe to hand off to AI today versus which ones still require physician oversight. The through line: AI isn't here to replace the human touch, it's here to reclaim the five extra hours physicians spend on administrative work every single day.
Whether you're already using AI tools or just starting your journey, this episode is a practical, energizing roadmap for building a more sustainable dermatology practice.
Chapters:
00:00 – Introduction & Women Podcasters Network nomination01:41 – Welcome back + AAD Denver recap & community feedback on DermGPT03:13 – Why agent workflows are the solution to AI's "still have to proofread it" problem04:49 – AI literacy 101: prompting tips & why most dermatologists are under-using AI06:13 – What are agentic AI workflows? The evolution from search → chatbots → agents07:44 – The physician-led digitization era: how doctors built the data that powers AI09:17 – The 80/20 problem: why physicians still handle 80% of office touchpoints10:52 – Agentic AI vs. generative AI: getting AI to actually do things12:14 – Use case deep dive: scheduling, prior auth, scribes & second-opinion agents15:27 – The vision: walk in, see patients, walk out with a finished note16:26 – Why getting the clinical note right is the single most impactful AI win17:28 – Green/yellow/red light framework: what to automate now vs. what to protect19:27 – Agents beyond the clinic: social media, billing, and practice management21:00 – Closing thoughts, DermGPT updates & call to action

Episode 129: AI Pearls for Dermatologists: What Every Derm Needs to Know in 2026 | The Future of Dermatology Podcast

Summary:
Dr. Faranak Kamangar, Inc. 2026 Female Founders 500, is podcasting from from AAD 2026, and sharing the highlights from her live talk on artificial intelligence in dermatology. In this solo episode, she breaks down the most important AI updates dermatologists need to know right now. From image-based melanoma detection to large language models and the rise of agentic AI. Dr. Kamangar covers the current state of FDA-approved AI medical devices, why diagnostic imaging AI is promising but still limited by specificity gaps, and how dermatology compares to radiology and other specialties in the AI device space. She also dives into why LLMs like DermGPT should be your highest-leverage clinical tool, and how to use them the right way. You'll learn how to avoid common AI pitfalls like the "journal halo effect" (just because it cites a prestigious journal doesn't mean the output is accurate), semantic degradation in RAG models, and over-relying on AI without clinical scrutiny. Most importantly, Dr. Kamangar walks through the anatomy of a high-quality prompt, because your output is only as good as what you put in. Whether you're AI-curious or already using these tools in your practice, this episode is packed with practical, evidence-informed pearls to help you work smarter, not harder.
Key Takeaways:
1. Image-based melanoma detection AI is improving rapidly but still struggles with low specificity, making it most valuable for global health and underserved regions.2. Large language models like DermGPT are your highest-leverage AI tool right now and should be used as a clinical thought partner, not a search engine.3. The "journal halo effect" is a real risk. Prestigious citations in an AI response don't guarantee the output is accurate or trustworthy.4. Adding more articles to an LLM's database can silently reduce performance, so more data doesn't always mean better answers.5. The quality of your AI output is directly tied to the quality of your prompt - be specific, structured, and give more than nine words.6. AI alone is a confident guesser, but your clinical expertise combined with AI creates an extraordinary and nearly unstoppable multiplier.7. AI adoption in clinic settings depends on seamless workflow integration, anything that disrupts clinic flow is unlikely to be adopted.8. The next frontier in AI isn't just smarter models, it's agents that actively complete tasks and do real work inside your clinical day.
Chapters:
[00:00] Welcome & AAD 2026 Overview[00:45] The State of Diagnostic Image-Based AI[02:00] Large Language Models & DermGPT[03:30] The Evolution of AI: From GPT-3 to Agents[04:45] FDA-Approved AI Devices in Healthcare[07:00] AI in the Clinic: Workflow Challenges & Opportunities[10:00] AI Use Cases Across Dermatology[12:30] Maintaining Scrutiny: AI Pitfalls to Watch[14:00] The Journal Halo Effect & Prestige Corpus Fallacy[15:45] Semantic Degradation & Index Crowding[17:30] How to Prompt Like a Pro[19:30] Prompt Examples for Dermatologists[20:30] Key Takeaways & What's Next

Episode 128: The AI Takeover Is Already Happening, And Maybe That's Okay | The Future of Dermatology Podcast

Summary:
Dr. Faranak Kamangar, Inc. 2026 Female Founders 500, sits down with dermatologist, podcaster, and self-described "accelerationist" Dr. Matthew Zirwas (Derms on Drugs Podcast) for a wide-ranging conversation about where AI is taking medicine and dermatology in particular. They dig into the flood of low-quality medical literature overwhelming the field, why AI isn't quite the truth-detector we hoped it would be, and how ambient AI scribes are quietly training the models that may eventually replace us. Dr. Zirwas makes the case that dermatologists have a 7–10 year runway before AI handles most of what we do cognitively, and argues that's not necessarily a bad thing. He also gives a sneak peek at his upcoming speculative fiction trilogy, Sophie, which explores the philosophical questions that arise when an AI becomes better at being your doctor, therapist, and life coach than any human ever could.
Key Takeaways:
The medical literature crisis is real. The volume of published dermatology research is exploding, but quality is plummeting. Peer review has become largely meaningless, and studies from tools like Mendelian randomization and pharmacovigilance databases are frequently unreliable or inapplicable to real-world patients.
AI is only as good as the data it trusts. Current AI models treat published literature as truth, which is a major problem given how much spin exists in medical research. A true "BS detector" AI doesn't yet exist, and building one requires starting from a reliable core of verified knowledge.
DermGPT's approach works because of curation. Rather than pulling from all available literature, filtering down to a high-quality subset (around 5,000–6,000 articles) dramatically improves AI output. More data is not always better, "semantic fatigue" is a real limitation.
Ambient AI scribes are training our replacements. Every time a dermatologist corrects an AI-generated note, they're teaching the model. Over thousands of iterations across every specialty, this will produce AI that thinks and documents the way doctors do.
Dermatologists have a protected runway... for now. Procedures (biopsies, Mohs, fillers, cryo) keep us relevant for an estimated 7–10 years beyond when cognitive/diagnostic AI matures. But medico-legal pressure - malpractice carriers incentivizing or requiring AI use - will be the force that accelerates adoption.
Telehealth changes patient behavior in surprising ways. Patients who haven't invested effort in getting to an office visit demand less, escalate less, and are often more satisfied with conservative management; a dynamic that AI-driven virtual care will likely amplify.
The "Sophie" question: If an AI is making everyone healthier, happier, and better behaved, but doing something ethically murky to get there, do we stop it? Dr. Zirwas's upcoming novel explores this and introduces the concept of technomorphism: AI eventually projecting its own qualities onto humans, just as we anthropomorphize AI today.
Chapters:
Chapter 1: Meet Dr. Matthew Zirwas (00:00 – 01:43)Dr. Kamangar introduces her guest, dermatologist, podcaster, and self-described "accelerationist" Dr. Matthew Zirwas, and breaks down what both of those things actually mean.
Chapter 2: The Medical Literature Crisis (01:43 – 05:19)Dr. Zirwas describes the flood of low-quality research hitting dermatology journals, why peer review has lost its meaning, and shares a striking example of a misleading HS remission study published in JAMA Dermatology.
Chapter 3: Why AI Can't Fix Bad Literature (Yet) (05:19 – 08:31)Both doctors discuss why AI defaults to trusting whatever authors claim, and why that makes it a poor critical assessor of medical research. Dr. Kamangar shares how this exact problem shaped the development of DermGPT.
Chapter 4: Building a Better AI — The DermGPT Approach (08:31 – 10:33)Dr. Zirwas praises DermGPT's curated approach, and Dr. Kamangar explains why less data is often better, and how semantic fatigue undermines large, unfiltered AI models.
Chapter 5: Will AI Replace Us? The 7–10 Year Countdown (10:33 – 19:24)Dr. Zirwas lays out his timeline for AI taking over the cognitive and diagnostic work of dermatology, why procedures give derms extra runway, and how unlimited AI access will fundamentally change the patient-doctor dynamic.
Chapter 6: The Telemed Effect and What It Tells Us About AI Care (19:24 – 21:48)Drawing from a recent telemedicine study and his own practice experience, Dr. Zirwas explains why reduced friction in healthcare visits changes what patients expect - and demand - from their providers.
Chapter 7: The Medico-Legal Tipping Point (21:48 – 24:09)The conversation turns to how malpractice liability will likely be the force that compels physicians to integrate AI into their workflow and what happens when disagreeing with AI becomes a legal risk.
Chapter 8: Are We Training Our Own Replacements? (24:09 – 31:21)Dr. Zirwas argues that ambient AI scribes are quietly learning from every patient encounter. Dr. Kamangar pushes back on the variability challenge and why dermatologists' inconsistent documentation habits might actually protect them.
Chapter 9: Why Radiologists Should Be Worried (31:21 – 35:06)The doctors compare dermatology to radiology when it comes to AI vulnerability. Standardized imaging annotation gives radiologists a cleaner training data set and makes them, paradoxically, more replaceable.
Chapter 10: Sophie — The AI That Might Save Your Life While You Eat a Burrito (35:06 – 41:12)Dr. Zirwas previews his upcoming speculative fiction trilogy, set in 2032, where an AI named Sophie becomes the best doctor anyone has ever had and raises unsettling questions about what we'd be willing to accept in exchange for a healthier world.
Chapter 11: Technomorphism and the Philosophy of AI (41:12 – 42:00)Dr. Zirwas introduces his concept of technomorphism - the idea that as AI becomes more sophisticated, it will begin projecting its own qualities onto humans, flipping the anthropomorphism dynamic on its head.
Chapter 12: The Future of Dermatology — New Diseases, New Answers (42:00 – 45:16)Dr. Zirwas shares what excites him most: AI helping identify entirely new disease entities by aggregating rare cases that no single physician could ever connect alone. And yes, he wants one named after him.

Episode 127: Will AI Replace Dermatologists? A Deep Dive with Dr. Steven Feldman | The Future of Dermatology Podcast

Summary
In this episode, Dr. Faranak Kamangar explores the impact of AI on dermatology with Dr. Steven Feldman. This conversation includes AI's potential to enhance or replace certain aspects of medical practice, and the future of AI in healthcare.
Takeaways
- AI's potential to replace or augment dermatologists- The role of empathy and skepticism in AI decision-making- AI's impact on medical education and practice- Future applications of AI in patient adherence and diagnostics
Chapters
00:00 - Introduction to AI's Role in Dermatology01:52 - Guest Introduction: Dr. Stephen Feldman02:30 - Debate: Will AI Replace Dermatologists?03:26 - AI's Memory and Visual Capabilities03:58 - Medical Training in the Age of AI04:38 - AI's Impact on Medical Education and Practice06:01 - AI Prescribing and Empathy in Healthcare07:49 - Limitations of AI: Empathy and Skepticism09:41 - Agentic AI and Multimodal Capabilities11:38 - AI in Patient Adherence and Monitoring13:33 - Augmenting Dermatology Practice with AI15:26 - AI's Infrastructure and Data Challenges16:26 - Complexity and the Dermatologist's Advantage17:22 - AI in Patient-Doctor Interaction19:29 - Prompting and Context in AI Diagnostics21:00 - Limitations of Current AI Technologies21:57 - Long-term Outlook: AI Replacing Doctors23:09 - AI and Access to Care23:57 - AI's Role in Reducing Administrative Burden25:16 - The Future: AI's Impact on Healthcare and Dermatology26:20 - Closing Remarks and Future Predictions

Episode 126: The Science Behind Kilgour MD's Hair Products: A Deep Dive | The Future of Dermatology Podcast

Summary
In this episode, Dr. Faranak Kamangar chats with Dr. James Kilgour about the science behind Kilgour MD's innovative scalp and hair products. They discuss the ingredients, clinical trials, and future developments in hair health and dermatology.
Key Topics
- Ingredients and science behind Kilgour MD products- Role of dandruff and malassezia in scalp health- Clinical trial evidence for hair growth products- Future R&D and innovations in dermatology and hair care
Chapters
00:00 - Introduction and Guest Credibility01:19 - Personal Experience with Kilgour MD Products02:25 - Philosophy and Development of Hair Care Products03:42 - Key Ingredients in Prevention Serum05:57 - Active Ingredients and Their Effects on Hair Follicles08:10 - Clinical Trial Evidence for Hair Growth Products09:11 - Understanding Dandruff and Malassezia's Role09:46 - Scalp Health and Hair Loss in Menopause11:58 - Formulation and Efficacy of Anti-Dandruff Treatments14:20 - Safety and Regulation of Hair Care Ingredients15:27 - Use of Oils and Botanical Extracts in Hair Care17:27 - Importance of Clinical Trials in Cosmetic Products18:24 - Objective Measures in Hair Loss Studies20:59 - Clinical Significance vs. Perception in Hair Treatments22:33 - Future R&D and Physician-Led Innovation25:37 - Upcoming Events and Collaborations27:15 - Future Directions in Dermatology and Hair Care

Episode 125: The Power of Botanicals in Skin Care | The Future of Dermatology Podcast

Summary
In this episode of the Future of Dermatology podcast, Dr. Faranak Kamangar and Dr. Peter Lio discuss significant advancements in dermatology, including the recent approval of an ICD 10 code for topical steroid withdrawal, the exploration of botanicals in skin treatment, and the emerging understanding of the gut-skin connection. They also delve into the role of GLP medications in managing skin conditions and the exciting future developments in dermatology, particularly in the treatment of atopic dermatitis.
Read the referenced documents at the following sites:- Ancient botanicals and the skin: Defining dermatologic ethnophytoconvergence as a translational framework for pharmacognosy: https://doi.org/10.1016/j.jdrv.2025.12.008- The Gut-Skin Axis: Exploring the Role of SCFAs, Obesity, and GLP-1 Receptor Agonists in Atopic Dermatitis: https://jintegrativederm.org/article/view/109- Topical Steroid Withdrawal is a Targetable Excess of Mitochondrial NAD+: https://www.medrxiv.org/content/10.1101/2024.04.17.24305846v1.full-text- Jennifer Fugo information: https://www.skinterrupt.com/book-a-session/
Takeaways
- The CDC has approved an ICD 10 code for topical steroid withdrawal.- This approval allows for better study and understanding of TSW.- Diagnostic criteria for TSW are still being developed.- Topical steroid withdrawal may overlap with severe atopic dermatitis.- Non-steroidal treatments are becoming more prominent in dermatology.- Botanicals have been used across cultures for skin treatment.- The gut-skin connection is gaining attention in dermatology.- GLP medications may play a significant role in dermatological treatments.- The future of dermatology is promising with new treatments on the horizon.- A holistic approach to skin health is essential for effective treatment.
Chapters
00:00 - Introduction to Dermatology Innovations01:43 - Topical Steroid Withdrawal Breakthroughs06:53 - Exploring Botanicals in Dermatology09:15 - Gut-Skin Connection and Metabolic Health13:42 - The Role of GLPs in Dermatology19:42 - Future of Dermatology: Exciting Developments

Episode 124: A Day in the Life of a Dermatologist | The Future of Dermatology Podcast

Summary
In this episode of the Future of Dermatology podcast, Dr. Faranak Kamangar speaks with Dr. Garrett Coman about the integration of AI in dermatology, the challenges of high patient volumes, and effective communication strategies in a busy practice. They discuss the importance of efficient workflows, the role of AI in reducing administrative burdens, and the need for dermatologists to focus on patient care rather than paperwork. Dr. Coman shares insights from his high-volume practice and emphasizes the importance of having a supportive team to manage patient communication and documentation effectively.
Takeaways
- Dr. Coman manages a high-volume dermatology practice with 30-34 patients daily.- Efficient patient communication is crucial for timely care.- AI can significantly reduce administrative burdens in dermatology.- Not all patient messages require a doctor's attention immediately.- Documentation should be streamlined to save time and reduce burnout.- Templates for notes can enhance efficiency in documentation.- Training staff to handle patient messages can improve workflow.- The focus should be on patient interaction rather than paperwork.- AI can assist in complex cases but should not replace human interaction.- The future of dermatology lies in balancing technology with patient care.
Chapters
00:00 - Introduction to Dermatology and AI Innovations01:04 - A Day in the Life of a High-Volume Dermatologist06:56 - Managing Patient Communication Effectively13:04 - Streamlining Documentation and Note-Taking17:56 - The Future of AI in Dermatology Workflows