Frontal Fibrosing Alopecia: An Update on Pathogenesis, Diagnosis, and Treatment

The document from 2019 discusses Frontal Fibrosing Alopecia (FFA), a condition causing progressive hair loss, particularly in postmenopausal women. The exact cause of FFA is unknown, but potential triggers include hormones, inflammation, smoking, UV filters, and facial products, with a genetic predisposition also suggested. Diagnosis is primarily clinical, supported by trichoscopy, and sometimes requires pathology. Treatment options include topical corticosteroids, minoxidil, calcineurin inhibitors, systemic treatments like 5-alpha-reductase inhibitors, hydroxychloroquine, retinoids, and other therapies such as pioglitazone, naltrexone, tofacitinib, and laser treatments. However, the efficacy of these treatments is uncertain due to the lack of randomized clinical trials. The document also discusses the Frontal Fibrosing Alopecia Severity Index (FFASI) for assessing severity and notes that prognosis is generally slow progression with rare partial regrowth. The need for larger studies to validate potential markers of FFA activity is emphasized, as current treatment remains experience-based.