5-Alpha-Reductase Inhibitor Treatment for Frontal Fibrosing Alopecia: An Evidence-Based Treatment Update

March 2018 in “ JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology ”

Aizuri Murad, Wilma F. Bergfeld

5-alpha-reductase inhibitors finasteride dutasteride frontal fibrosing alopecia disease stabilization hair regrowth adverse effects malignancy sexual issues psychiatric issues 5ARI Propecia Avodart FFA

TLDR 5-alpha-reductase inhibitors may help stabilize or slow down hair loss in some frontal fibrosing alopecia patients, but more research is needed to confirm their effectiveness and safety.

The review analyzed the efficacy and safety of 5-alpha-reductase inhibitors (5ARI), specifically finasteride and dutasteride, in treating frontal fibrosing alopecia (FFA). It included 14 studies with 270 patients, showing that dutasteride was more effective, with disease stabilization in 37.3% to 55.6% of patients and some hair regrowth, while finasteride showed disease stabilization in 47% to 52.9% of patients and minimal hair regrowth in 32.1% of cases. Despite positive outcomes, the use of 5ARI remained off-label with concerns about long-term safety, especially in women. The review emphasized the need for randomized, double-blind, placebo-controlled studies to confirm 5ARI's efficacy and highlighted potential adverse effects, including malignancy, sexual, and psychiatric issues.

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Research cited in this study

17 / 17 results

research Frontal Fibrosing Alopecia: Clinical and Prognostic Classification

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research Finasteride-Mediated Hair Regrowth and Reversal of Atrophy in a Patient with Frontal Fibrosing Alopecia

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Finasteride helps hair regrowth in frontal fibrosing alopecia.

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Most patients with frontal fibrosing alopecia are postmenopausal women, and treatments like finasteride and dutasteride can improve or stabilize the condition.

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Dutasteride may help stabilize Frontal Fibrosing Alopecia, but more research is needed.

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research Treatment of Postmenopausal Frontal Fibrosing Alopecia with Oral Dutasteride

64 citations , June 2009 in “Journal of The American Academy of Dermatology”

Oral dutasteride can potentially treat frontal fibrosing alopecia in postmenopausal women, with some patients showing disease arrest and hair regrowth.

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69 citations , August 2008 in “Journal of The European Academy of Dermatology and Venereology”

Oral dutasteride and topical pimecrolimus can safely and effectively treat Frontal Fibrosing Alopecia, leading to significant hair regrowth.

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Finasteride improves acne and hair loss in women with normal testosterone.

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123 citations , August 2005 in “Journal of the European Academy of Dermatology and Venereology”

The study found that Frontal Fibrosing Alopecia affects a broader age range of women and early treatment can help stop hair loss.

research Frontal Fibrosing Alopecia in Postmenopausal Women

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Some postmenopausal women with frontal fibrosing alopecia stopped losing hair with finasteride treatment, hinting at a possible hormonal cause.

research Use of Cyproterone Acetate, Finasteride, and Spironolactone to Treat Idiopathic Hirsutism

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All three treatments reduce hirsutism, but spironolactone works best long-term.

research Depression Related to Finasteride Administration for Androgenetic Alopecia

88 citations , October 2002 in “Journal of Dermatology”

Finasteride for hair loss may cause depression, affecting sleep and relationships.

research Immunohistochemical Localization of Types 1 and 2 5α-Reductase in Human Scalp

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The study found that two enzymes linked to hair loss are located in different parts of the scalp, supporting a common treatment's effectiveness.

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