Algorithm Proposal for Hair Transplantation in Fibrosing Alopecia Pattern Distribution

    May 2022 in “ Journal of Cosmetic Dermatology ”
    Alba Gómez-Zubiaur, C Valenzuela, J J Andrés-Lencina, Ana Rodriguez-Villa, J M Ricart
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    TLDR The authors suggest a method for hair transplantation in fibrosing alopecia pattern distribution to improve treatment outcomes and cover bald areas.
    Fibrosing alopecia pattern distribution (FAPD) is a recently identified condition that combines features of non-scarring alopecia, like androgenic alopecia, and lichenoid inflammatory cicatricial alopecia. The diagnosis of FAPD can be challenging due to the lack of uniform diagnostic criteria, which can lead to overdiagnosis. Key diagnostic features include loss of follicular openings on trichoscopy and fibrosis on histopathology. The use of hair transplantation as a treatment for FAPD is controversial, with no clear consensus in the scientific community. The presence of histological lichenoid inflammatory infiltrates could make this treatment option less suitable. However, based on limited data from hair transplantation in other lymphocytic lichenoid inflammatory alopecias, such as lichen planus pilaris (LPP) and frontal fibrosing alopecia (FFA), the authors propose an algorithm for hair transplantation in FAPD to optimize treatment results and maximize coverage of the alopecic area.
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