Clinical Characteristics, Trichoscopy, Histopathology, and Treatment Outcomes of Frontal Fibrosing Alopecia in an Asian Population: A Retro-Prospective Cohort Study

In a retro-prospective cohort study of 58 Asian female patients with Frontal Fibrosing Alopecia (FFA), researchers found that 69% experienced eyebrow loss, 32.8% had facial papules, and 91.4% showed a lack of follicular ostia on trichoscopic examination. Histopathological examination in 14 patients commonly revealed perifollicular fibrosis (92.9%) and lymphocytic infiltration (78.6%). The study concluded that antiandrogens or antimalarials combined with topical treatments were effective, with up to 90% of patients seeing improvement or stabilization. The "Front puff" Thai hairstyle was associated with FFA, suggesting hair trauma from repeated pulling as a potential factor. Facial lentiginous macules and trichoscopic perifollicular erythema were identified as factors associated with FFA severity. The study highlighted differences in FFA symptoms and clinical features among different ethnic groups and noted that eyebrow tattooing in Thailand may obscure the recognition of eyebrow hair loss. Despite its insights, the study had limitations such as a small sample size and potential for recall bias.