5-Alpha-Reductase Inhibitor Treatment for Frontal Fibrosing Alopecia: A Myth or Truth?

The document discusses the use of 5-Alpha-Reductase (5AR) inhibitors, such as finasteride and dutasteride, in treating Frontal Fibrosing Alopecia (FFA), a condition primarily affecting postmenopausal women. The study reviews various reports and observational studies, including a meta-analysis by Murad et al., which evaluated 14 papers and treated 121 patients with finasteride and 149 with dutasteride. The results showed disease stabilization or slowed progression, with very few instances of hair regrowth. However, the efficacy of 5AR inhibitors and their long-term safety in women remain uncertain due to the lack of randomized controlled studies and potential confounding factors. The document concludes that 5AR inhibitors are most effective in treating FFA when used in combination with other treatments, particularly in postmenopausal women. The evidence is currently of low quality and subjective, and 5AR inhibitors are generally used as an adjunct rather than a primary treatment option. Further double-blinded randomized controlled studies are suggested for better treatment options.