Finasteride Is of Uncertain Utility in Treating Frontal Fibrosing Alopecia

This article is a letter to the editor in response to a report on the potential of finasteride as a treatment for frontal fibrosing alopecia. The authors of the letter argue that the conclusions of the report are misleading and not supported by current evidence. They point out that the studies cited in the report had limitations, such as the use of concurrent topical minoxidil and the presence of androgenetic alopecia. The authors also question the mechanistic plausibility of using a 5a-reductase inhibitor to treat an immune-mediated primary lymphocytic cicatricial alopecia. They caution that objective evidence should always come first in guiding clinical practice.