Frontal Fibrosing Alopecia: A Multicenter Review of 355 Patients

The document reports on a retrospective multicenter study of 355 patients (343 females and 12 males) with Frontal Fibrosing Alopecia (FFA), a rare type of scarring hair loss primarily observed in postmenopausal women. The study aimed to describe the epidemiology, comorbidities, clinical aspects, diagnostic findings, and therapeutic choices for FFA. The mean age of the patients was 61 years, with a range of 23-86 years. Notably, early menopause (before 45 years) was detected in 49 patients (14%), with a surgical cause in 31 of them (9%). Severe FFA was observed in 131 patients (37%), with independent factors associated with severe FFA being eyelash loss, corporal hair involvement, and the presence of facial papules. Treatment with oral antiandrogens like finasteride (used in 102 patients, with 47% improvement and 53% stabilization) and dutasteride (used in 18 patients, with 44% improvement and 56% stabilization) showed potential benefits. The study highlighted a possible hormonal pathogenesis of FFA, given the high rate of early menopause or hysterectomy among the women with FFA, and suggested that oral antiandrogens and intralesional steroids may be useful treatments.