Fibrosing Alopecia in a Pattern Distribution

July 2018 in “ Elsevier eBooks ”

Ralph M. Trüeb, Maria Fernanda Reis Gavazzoni Dias

TLDR FAPD and possibly CCCA may be AGA subtypes, and treatments combining antiandrogens, hair growth agents, hair transplants, and anti-inflammatories could be effective.

The document from 2019 discusses Fibrosing Alopecia in a Pattern Distribution (FAPD), a type of scarring alopecia that presents similarly to Androgenetic Alopecia (AGA) but includes a lichenoid tissue reaction. AGA treatments like antiandrogens, 5a-reductase inhibitors, and minoxidil have limited success, suggesting that follicular inflammation and fibrosis may play a role in the condition. FAPD is characterized by histopathologic features of lichen planopilaris (LPP) and may coexist with Frontal Fibrosing Alopecia (FFA), with an autoimmune pathogenesis suggested for these conditions. The document also covers Central Centrifugal Cicatricial Alopecia (CCCA), which predominantly affects women of African origin and is associated with type 2 diabetes, bacterial scalp infections, and certain hairstyles. The study by Kyei et al. is referenced, but the number of participants is not mentioned. The conclusion is that FAPD and possibly CCCA should be considered subtypes of AGA, and that combined treatments including antiandrogens, hair growth agents, hair transplantation, and anti-inflammatory treatments may be effective for these conditions.

View this study on sciencedirect.com →

Discuss this study in the Community →

Research cited in this study

23 / 23 results

research Cutaneous Lupus Erythematosus Presenting as Frontal Fibrosing Alopecia: Report of 2 Patients

12 citations, January 2017 in “Skin appendage disorders”

Two patients with skin lupus were mistakenly thought to have a different scalp condition but improved with lupus treatment.

research Clinical and Histological Study of Permanent Alopecia After Bone Marrow Transplantation

23 citations, December 2015 in “Anais Brasileiros de Dermatologia”

Permanent hair loss after bone marrow transplant can be caused by chemotherapy or chronic graft-versus-host disease.

research Nail Involvement in Frontal Fibrosing Alopecia

17 citations, January 2015 in “International Journal of Trichology”

Frontal fibrosing alopecia may affect nails and could be a type of lichen planus, treatable with certain medications.

research Pathologic Diagnosis of Central Centrifugal Cicatricial Alopecia on Horizontal Sections

29 citations, September 2014 in “American Journal of Dermatopathology”

Horizontal sections of scalp biopsies are good for diagnosing Central Centrifugal Cicatricial Alopecia and help customize treatment.

research Dermatoscopic Features of Central Centrifugal Cicatricial Alopecia

64 citations, June 2014 in “Journal of The American Academy of Dermatology”

Researchers found a white halo around hair in most patients with a specific type of hair loss, which helps in early diagnosis and treatment.

research Frontal Fibrosing Alopecia: A Retrospective Clinical Review of 62 Patients with Treatment Outcome and Long-Term Follow-Up

102 citations, April 2014 in “International Journal of Dermatology”

The treatment helped reduce symptoms and stabilize the hairline in most patients with Frontal Fibrosing Alopecia, but hair regrowth was limited.

research Frontal Fibrosing Alopecia: A Multicenter Review of 355 Patients

339 citations, February 2014 in “Journal of The American Academy of Dermatology”

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

research Lichen Planopilaris Is Characterized By Immune Privilege Collapse Of The Hair Follicle's Epithelial Stem Cell Niche

220 citations, June 2013 in “The Journal of Pathology”

Lichen planopilaris may be an autoimmune disease causing hair loss due to immune system issues in hair follicles.

research Frontal Fibrosing Alopecia: A Retrospective Review of 19 Patients Seen at Duke University

98 citations, February 2013 in “Journal of The American Academy of Dermatology”

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

research Frontal Fibrosing Alopecia: A Review of 60 Cases

166 citations, April 2012 in “Journal of The American Academy of Dermatology”

Mostly postmenopausal Caucasian women get Frontal Fibrosing Alopecia, which often includes eyebrow loss and has limited treatment success.

research Value of Trichoscopy Versus Trichogram for Diagnosis of Female Androgenetic Alopecia

45 citations, January 2012 in “International Journal of Trichology”

Trichoscopy is better than trichogram for diagnosing female hair loss.

research Medical and Environmental Risk Factors for the Development of Central Centrifugal Cicatricial Alopecia

88 citations, April 2011 in “Archives of Dermatology”

Type 2 diabetes, bacterial scalp infections, and tight hairstyles like braids and weaves are linked to a higher risk of a scarring hair loss condition in African American women.

research Frontal Fibrosing Alopecia: A Clinical Review of 36 Patients

159 citations, August 2010 in “British journal of dermatology/British journal of dermatology, Supplement”

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

research Anisotrichosis: A Novel Term to Describe Pattern Alopecia

25 citations, April 2007 in “Journal of The American Academy of Dermatology”

The document suggests "anisotrichosis" as a new term for hair thickness variation in common baldness.

research Histological Features of Peripilar Signs Associated with Androgenetic Alopecia

95 citations, January 2004 in “Archives of Dermatological Research”

Peripilar signs can help diagnose androgenetic alopecia and reveal its cause.

research Molecular Mechanisms of Androgenetic Alopecia

229 citations, August 2002 in “Experimental Gerontology”

AGA causes hair loss by shrinking hair follicles due to DHT binding, and can be treated with finasteride and minoxidil.

research Androgenetic Alopecia and Microinflammation

131 citations, August 2000 in “International Journal of Dermatology”

Inflammation may be linked to hair loss, and targeting specific enzymes could help treat it.

research Fibrosing Alopecia in a Pattern Distribution

158 citations, February 2000 in “Archives of dermatology”

Some people with pattern hair loss may also have scalp inflammation and scarring similar to lichen planopilaris.

research Treatment of Hair Loss

370 citations, September 1999 in “The New England Journal of Medicine”

Finasteride and minoxidil are effective for hair loss, but continued research is needed for better treatments.

research The Biology of Hair Follicles

1113 citations, August 1999 in “The New England Journal of Medicine”

Hair follicle biology advancements may lead to better hair growth disorder treatments.

research Postmenopausal Frontal Fibrosing Alopecia: A Frontal Variant of Lichen Planopilaris

329 citations, January 1997 in “Journal of the American Academy of Dermatology”

Frontal fibrosing alopecia is a hair loss condition in postmenopausal women, similar to lichen planopilaris, with ineffective treatments.

research Diagnostic and Predictive Value of Horizontal Sections of Scalp Biopsy Specimens in Male Pattern Androgenetic Alopecia

309 citations, May 1993 in “Journal of The American Academy of Dermatology”

Horizontal scalp biopsy sections effectively diagnose and predict MPAA, with follicular density and inflammation impacting hair regrowth.

research Classification of the Types of Androgenetic Alopecia (Common Baldness) Occurring in the Female Sex

666 citations, September 1977 in “British Journal of Dermatology”

Common baldness, also known as Androgenetic Alopecia, is caused by a combination of genetic factors and hormones called androgens.

Related Community Posts Join

6 / 146 results

community Fibrosing alopecia in a pattern distribution

in Research/Science 14 upvotes 9 months ago

A user has been experiencing hair loss for 4 years, with treatments like minoxidil, finasteride, and various supplements proving ineffective. They were diagnosed with fibrosing alopecia in a pattern distribution, a condition that may require a combination of anti-inflammatory and hair growth treatments.

community scarring alopecia awareness in this community

in Chat 33 upvotes 2 years ago

Lichen Planopilaris (LPP), a form of permanent hair loss, which can be mistaken for seborrheic dermatitis and is characterized by scalp itching, burning, redness, and dandruff. Treatment options discussed include steroidal creams, finasteride, minoxidil, and RU58841.

community Diffuse hair loss and scalp biopsies

in Research 692 upvotes 4 months ago

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

community Scalp tension and thickness of the galea aponeurotica, inflammation and potential treatment pathways

in Research/Science 2 years ago

Scalp tension potentially affecting hair loss, and potential treatments for male pattern baldness such as Minoxidil, Finasteride and RU58841. Evidence from a study was discussed which suggests that the cause of MPB lies within the follicle itself and is not dependent on its surrounding environment.

community I’ve been on dutesteride and oral minoxidil for two years now and I’ve only lost ground… 25m What should I do?

in Treatment 33 upvotes 8 months ago

A user on dutasteride and oral minoxidil for two years has experienced worsening hair loss and an itchy scalp. Suggestions include increasing medication doses, trying other treatments like RU58841, getting a scalp biopsy, and addressing potential inflammation through diet and topical treatments.

community Turning vellus hairs into terminal hair

in Research/Science 12 upvotes 2 months ago

People are discussing hair loss treatments, including minoxidil, finasteride, and RU58841, to turn vellus hairs into terminal hairs. Some users also mention using antibiotics, oral minoxidil, dutasteride, DHT blockers, biotin, and natural remedies like onion juice and seeds to improve hair growth.

Related Research

6 / 6 results

research Feature Characterization of Scarring and Non-Scarring Types of Alopecia by Multiphoton Microscopy

24 citations, September 2018 in “Lasers in Surgery and Medicine”

Multiphoton microscopy can non-invasively tell apart scarring from non-scarring hair loss and could aid in treatment.

research Hair Disorders

August 2018 in “Oxford University Press eBooks”

The document's conclusion cannot be provided because the document cannot be parsed.

research Hair Follicle Plasticity with Complemented Immune-Modulation Following Follicular Unit Extraction

4 citations, January 2015 in “International Journal of Trichology”

Transplanted hair follicles can change and adapt to new areas of the body, with the immune system possibly playing a role in this adjustment.

research Standardization of Trichotillometer

March 2009

Trichotillometry can measure hair plucking force, aiding alopecia treatment evaluation.

research Evaluation of Hair Loss

21 citations, May 1996 in “Current problems in dermatology”

Detailed patient history and physical exams are crucial for diagnosing hair loss.

research Androgenetic Alopecia, Trichotrophic Substances, and Histologic Studies of the Human Scalp

5 citations, October 1988 in “Clinics in Dermatology”

Minoxidil promotes hair growth but exact mechanism is unknown.