Guidelines for Clinical Trials of Frontal Fibrosing Alopecia: Consensus Recommendations from the International FFA Cooperative Group

August 2021 in “ British journal of dermatology/British journal of dermatology, Supplement ”

Elise A. Olsen, Matthew Harries, Antonella Tosti, Wilma F. Bergfeld, Ulrike Blume-Peytavi, Valerie D. Callender, Vasiliki Chasapi, Osvaldo Correia, George Cotsarelis, Rachita Dhurat, Ncoza C. Dlova, Isabella Doche, Nkechi Anne Enechukwu, Ramón Grimalt, Satoshi Itami, Maria Hordinsky, Kuzma Кhobzei, W. S. Lee, Subrata Malakar, Andrew G. Messenger, Amy J. McMichael, Paradi Mirmirani, Yuliya Ovcharenko, Sofia Papanikou, Giselle Martins Pinto, Bianca Maria Piraccini, Rodrigo Pirmez, P. Reygagne, Janet L. Roberts, Lidia Rudnicka, David Saceda‐Corralo, Jerry Shapiro, Tatiana Silyuk, Rodney Sinclair, Rui Oliveira Soares, A. Souissi, Annika Vogt, Ken Washenik, Abraham Zlotogorski, Douglas Canfield, Sergio Vañó‐Galván

frontal fibrosing alopecia FFA Global Staging Score ALODEXFFA Score hair density treatment efficacy diagnostic criteria severity rating staging assessment methods

TLDR Experts agreed on guidelines to improve research on Frontal Fibrosing Alopecia.

The document outlines consensus recommendations from the International FFA Cooperative Group (IFFACG) for clinical trials on Frontal Fibrosing Alopecia (FFA), aiming to standardize diagnostic criteria, severity rating, staging, and assessment methods. The IFFACG, comprising hair loss experts, achieved over 90% agreement on these guidelines to ensure consistent and meaningful data collection on FFA worldwide. This will enhance clinical and basic research on well-defined patient populations and facilitate the evaluation of treatment efficacy and safety. The guidelines introduce a Global Staging Score and the ALODEXFFA Score for simplified assessment of hair density and extent, which are expected to improve data aggregation and support further research to fill existing knowledge gaps about FFA.

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research Clinical Characteristics, Trichoscopy, Histopathology, and Treatment Outcomes of Frontal Fibrosing Alopecia in an Asian Population: A Retro-Prospective Cohort Study

9 citations , July 2020 in “Journal of Dermatology”

Asian patients with Frontal Fibrosing Alopecia often lose eyebrow hair and respond well to combined antiandrogen or antimalarial and topical treatments.

research Sunscreen and Facial Skincare Products in Frontal Fibrosing Alopecia: A Case-Control Study

26 citations , January 2019 in “British Journal of Dermatology”

Regular use of sunscreen may be linked to frontal fibrosing alopecia.

research Frequency of the Types of Alopecia at Twenty-Two Specialist Hair Clinics: A Multicenter Study

56 citations , January 2019 in “Skin appendage disorders”

The most common hair loss type at specialist clinics is androgenetic alopecia, especially in younger men, followed by alopecia areata and telogen effluvium, with differences seen across regions.

research Objective Outcome Measures: Collecting Meaningful Data on Alopecia Areata

39 citations , September 2018 in “Journal of The American Academy of Dermatology”

The document suggests using standardized methods to track and measure hair loss in alopecia areata, including patient self-assessment and a 50% improvement in specific scores as a treatment goal.

research Frontal Fibrosing Alopecia: Review of Recent Case Reports and Case Series in PubMed

9 citations , August 2018 in “Journal der Deutschen Dermatologischen Gesellschaft”

Most patients with frontal fibrosing alopecia are middle-aged women, often have thyroid disease, and some treatments can help stabilize the condition.

research Lichen Planopilaris and Frontal Fibrosing Alopecia as Model Epithelial Stem Cell Diseases

80 citations , May 2018 in “Trends in Molecular Medicine”

Lichen Planopilaris and Frontal Fibrosing Alopecia may help us understand hair follicle stem cell disorders and suggest new treatments.

research Frontal Fibrosing Alopecia and Cutaneous Comorbidities: A Potential Relationship with Rosacea

18 citations , March 2018 in “Journal of the American Academy of Dermatology”

The document suggests a possible link between frontal fibrosing alopecia and rosacea.

research Lichen Planus Pigmentosus and Its Variants: Review and Update

94 citations , October 2017 in “International Journal of Dermatology”

Lichen planus pigmentosus causes dark skin patches and is treated by avoiding triggers and using anti-inflammatory medications.

research Yellow Facial Papules Associated With Frontal Fibrosing Alopecia: A Distinct Histologic Pattern and Response to Isotretinoin

32 citations , October 2017 in “Journal of the American Academy of Dermatology”

Oral isotretinoin effectively treats yellow facial papules in frontal fibrosing alopecia patients.

research Frontal Fibrosing Alopecia Among Men: A Clinicopathologic Study of 7 Cases

41 citations , October 2017 in “Journal of The American Academy of Dermatology”

Men with Frontal fibrosing alopecia typically lose hair on the front scalp and sometimes on sideburns and upper lip, with treatments showing varied success.

research Unusual Patterns of Presentation of Frontal Fibrosing Alopecia: A Clinical and Trichoscopic Analysis of 98 Patients

18 citations , July 2017 in “Journal of The American Academy of Dermatology”

Trichoscopy helps diagnose frontal fibrosing alopecia, even with unusual patterns.

research Hypopigmentation in Frontal Fibrosing Alopecia

23 citations , June 2017 in “Journal of the American Academy of Dermatology”

FFA patients have fewer melanocytes and thinner skin compared to others.

research Frontal Fibrosing Alopecia: Clinical and Prognostic Classification

74 citations , May 2017 in “JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology”

Researchers found three patterns of Frontal fibrosing alopecia, with Pattern III having the best prognosis after treatment.

research SALT II: A New Take on the Severity of Alopecia Tool for Determining Percentage Scalp Hair Loss

44 citations , December 2016 in “Journal of The American Academy of Dermatology”

The updated SALT II tool offers a more precise way to measure scalp hair loss.

research Effect of Minoxidil Topical Foam on Frontotemporal and Vertex Androgenetic Alopecia in Men: A 104-Week Open-Label Clinical Trial

20 citations , July 2016 in “Journal of The European Academy of Dermatology and Venereology”

Minoxidil foam promotes hair growth and reduces hair loss safely in men.

research It's Not All Traction: The Pseudo 'Fringe Sign' in Frontal Fibrosing Alopecia

39 citations , October 2015 in “British Journal of Dermatology”

The pseudo 'fringe sign' can also appear in frontal fibrosing alopecia, not just in traction alopecia, showing that this condition may be more common than thought.

research Frontal Fibrosing Alopecia: A Retrospective Clinical Review of 62 Patients with Treatment Outcome and Long-Term Follow-Up

102 citations , April 2014 in “International Journal of Dermatology”

The treatment helped reduce symptoms and stabilize the hairline in most patients with Frontal Fibrosing Alopecia, but hair regrowth was limited.

research Frontal Fibrosing Alopecia: A Multicenter Review of 355 Patients

339 citations , April 2014 in “Journal of The American Academy of Dermatology”

Most patients with frontal fibrosing alopecia are postmenopausal women, and treatments like finasteride and dutasteride can improve or stabilize the condition.

research Frontal Fibrosing Alopecia: A Retrospective Review of 19 Patients Seen at Duke University

98 citations , May 2013 in “Journal of The American Academy of Dermatology”

Dutasteride may help stabilize Frontal Fibrosing Alopecia, but more research is needed.

research Perifollicular Erythema as a Trichoscopy Sign of Progression in Frontal Fibrosing Alopecia

40 citations , January 2013 in “International journal of trichology”

Perifollicular erythema can indicate active frontal fibrosing alopecia.

research Frontal Fibrosing Alopecia: A Review of 60 Cases

166 citations , November 2012 in “Journal of The American Academy of Dermatology”

Mostly postmenopausal Caucasian women get Frontal Fibrosing Alopecia, which often includes eyebrow loss and has limited treatment success.

research Frontal Fibrosing Alopecia and Lichen Planus Pigmentosus: Is There a Link?

86 citations , October 2012 in “British journal of dermatology/British journal of dermatology, Supplement”

There may be a connection between Frontal Fibrosing Alopecia and Lichen Planus Pigmentosus, and more research is needed to confirm this.

research Lonely Hair

63 citations , October 2011 in “Archives of Dermatology”

Isolated long hairs at the original hairline can help diagnose Frontal Fibrosing Alopecia.

research Frontal Fibrosing Alopecia: A Clinical Review of 36 Patients

159 citations , November 2010 in “British journal of dermatology/British journal of dermatology, Supplement”

Hydroxychloroquine effectively reduces symptoms of frontal fibrosing alopecia, especially in the first 6 months.

research Acute Hair Loss on the Limbs in Frontal Fibrosing Alopecia: A Clinicopathological Study of Two Cases

31 citations , April 2010 in “British journal of dermatology/British journal of dermatology, Supplement”

Frontal fibrosing alopecia can cause sudden hair loss on limbs, similar to scalp hair loss.

research A Multicenter, Randomized, Placebo-Controlled, Double-Blind Clinical Trial of a Novel Formulation of 5% Minoxidil Topical Foam Versus Placebo in the Treatment of Androgenetic Alopecia in Men

142 citations , November 2007 in “Journal of The American Academy of Dermatology”

New 5% minoxidil foam effectively promotes hair growth and is safe for use.

research The Importance of Dual 5α-Reductase Inhibition in the Treatment of Male Pattern Hair Loss: Results of a Randomized Placebo-Controlled Study of Dutasteride Versus Finasteride

215 citations , December 2006 in “Journal of The American Academy of Dermatology”

Dutasteride more effective for hair growth, but has more side effects than finasteride.

research Frontal Fibrosing Alopecia: A Survey in 16 Patients

123 citations , August 2005 in “Journal of the European Academy of Dermatology and Venereology”

The study found that Frontal Fibrosing Alopecia affects a broader age range of women and early treatment can help stop hair loss.

research Current and Novel Methods for Assessing Efficacy of Hair Growth Promoters in Pattern Hair Loss

86 citations , February 2003 in “Journal of The American Academy of Dermatology”

New methods improve how we test hair growth treatments, but challenges like slow hair changes and high costs remain.

research Female Pattern Hair Loss

226 citations , September 2001 in “Journal of The American Academy of Dermatology”

Hair loss in women is genetic, diagnosed by examination and biopsy, and treated with minoxidil, finasteride, or transplantation.

research Development of a Health-Related Quality of Life Questionnaire for Women with Androgenetic Alopecia

31 citations , November 2000 in “Clinical and Experimental Dermatology”

WAA-QOL measures impact of hair loss on women's well-being.

research Lack of Efficacy of Finasteride in Postmenopausal Women with Androgenetic Alopecia

239 citations , November 2000 in “Journal of The American Academy of Dermatology”

Finasteride doesn't effectively treat hair loss in postmenopausal women.

research Fibrosing Alopecia in a Pattern Distribution

158 citations , February 2000 in “Archives of dermatology”

Some people with pattern hair loss may also have scalp inflammation and scarring similar to lichen planopilaris.

4 / 4 results

research The Changing Patterns of Hair Density and Thickness in South Korean Women with Hair Loss: Clinical Office-Based Phototrichogram Analysis

41 citations , December 2008 in “International Journal of Dermatology”

South Korean women with hair loss have lower hair density and thickness compared to healthy women.