Frontal Fibrosing Alopecia: Efficacy of Treatment Modalities

    Gamret AC, Potluri VS, Kandamaran Krishnamurthy, Fertig RM
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    Studysummary This review highlights available treatments for frontal fibrosing alopecia, noting that 5-alpha reductase inhibitors, intralesional steroids, and hydroxychloroquine currently have the most evidence supporting their use, while other treatments show variable results and require further study. Our plain-language summary of this paper — not a Tressless recommendation.
    Frontal fibrosing alopecia (FFA) was a challenging condition to treat, primarily affecting postmenopausal women and characterized by a receding frontotemporal hairline and eyebrow loss. The goal of treatment was disease stabilization rather than hair regrowth due to its scarring nature. At the time, there were no randomized controlled trials evaluating treatment efficacy, and knowledge was based on small retrospective studies. The review highlighted various treatment options, including 5-α-reductase inhibitors, intralesional steroids, and hydroxychloroquine, which had the highest level of evidence for treating FFA. Other therapies, such as topical steroids, calcineurin inhibitors, systemic retinoids, pioglitazone, oral antibiotics, minoxidil, excimer laser, and hair transplantation, showed variable results and required further data for definitive conclusions.
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