Frontal Fibrosing Alopecia in Men: A Review of the Literature

Frontal fibrosing alopecia (FFA) in men is an under-recognized condition often misdiagnosed due to its distinct clinical features, such as early beard and sideburn alopecia, facial papules, and body hair loss. The condition is believed to have an autoimmune basis influenced by genetic, hormonal, and environmental factors, including facial product use. Diagnosis is primarily clinical, supported by trichoscopy and biopsy, with eyebrow, sideburn, and beard alopecia being key indicators. Treatment strategies for men largely mirror those for women, focusing on disease stabilization with oral 5-alpha-reductase inhibitors, topical corticosteroids, and calcineurin inhibitors. However, current diagnostic criteria do not fully capture the male presentation, necessitating further research to validate diagnostic criteria and optimize treatment protocols for this underrepresented group.