Frontal Fibrosing Alopecia: Prospective Study of 20 Cases

    June 2017 in “ Annales de dermatologie et de vénéréologie ”
    Sara Elloudi, S. Gallouj, Mariame Meziane, Mernissi FZ, M. Rimani
    TLDR The study found that a specific type of hair loss is increasingly common in premenopausal women and can be effectively diagnosed and treated with various medications.
    This prospective study examined 20 cases of frontal fibrosing alopecia (FFA) over 16 months at the dermatology department of Hassan II University in Fez, Morocco. All patients were women with an average age of 46 years, and 65% were premenopausal. Dermoscopic examination revealed specific signs of FFA, and skin biopsies confirmed the diagnosis. Half of the patients had immune dysfunctions or other disorders. Treatments included topical corticosteroids, tacrolimus ointment, minoxidil 2%, hydroxychloroquine, and oral finasteride, with satisfactory results observed within one year. The study concluded that FFA is increasingly common in premenopausal women and that dermoscopy is valuable for diagnosis, guiding biopsies, evaluating treatment efficacy, and establishing prognosis.
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      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.

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      The conversation is about the role of testosterone in hair loss and the effectiveness of different treatments. The conclusion is that DHT is the main culprit for hair loss, and finasteride has been proven to work long-term in maintaining and regrowing hair. Testosterone may have a minor effect, but it is not the primary cause of hair loss.

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