Evaluating the Combined Efficacy of Oral Isotretinoin and Topical Tacrolimus Versus Oral Finasteride and Topical Tacrolimus in Frontal Fibrosing Alopecia: A Randomized Controlled Trial

July 2022 in “ Journal of Cosmetic Dermatology ”

Ghasem Rahmatpour Rokni, Seyed Naser Emadi, Abbas Dabbaghzade, Neda Jahantigh, Amir Mohammad Beyzaee, Aseem Sharma, Lidia Rudnicka, Mohamad Goldust

oral isotretinoin topical tacrolimus oral finasteride frontal fibrosing alopecia Physician Global Assessment FFA isotretinoin tacrolimus finasteride

TLDR Isotretinoin with tacrolimus may be more effective short-term for treating frontal fibrosing alopecia than finasteride with tacrolimus.

This randomized controlled trial evaluated the efficacy of oral isotretinoin and topical tacrolimus (group A) versus oral finasteride and topical tacrolimus (group B) in treating frontal fibrosing alopecia (FFA) in 31 patients over 12 weeks. Group A showed significantly better Physician Global Assessment (PGA) scores at 4 weeks (p=0.038) and higher, though not statistically significant, patient satisfaction at 8 and 12 weeks. No serious adverse effects were reported. The study suggests that isotretinoin combined with tacrolimus may be more effective in the short term for FFA treatment compared to finasteride with tacrolimus.

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Research cited in this study

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Some treatments like intralesional steroids and 5α-reductase inhibitors are effective for frontal fibrosing alopecia, but more research is needed.

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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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research Frontal Fibrosing Alopecia: A Clinical Review of 36 Patients

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Hydroxychloroquine effectively reduces symptoms of frontal fibrosing alopecia, especially in the first 6 months.

research Frontal Fibrosing Alopecia: Clinical Presentations and Prognosis

155 citations, September 2008 in “British journal of dermatology/British journal of dermatology, Supplement”

FFA is more common in postmenopausal women, can affect younger women, and may stabilize over time.

research Frontal Fibrosing Alopecia: Treatment with Oral Dutasteride and Topical Pimecrolimus

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.

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.

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