Optimal Management of Frontal Fibrosing Alopecia: A Practical Guide

    Reese L. Imhof, Stanislav N. Tolkachjov
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    TLDR Early diagnosis and combination therapy, especially with finasteride and dutasteride, are key to managing Frontal Fibrosing Alopecia effectively.
    The document reviews the management of Frontal Fibrosing Alopecia (FFA), emphasizing early diagnosis and treatment to prevent permanent hair loss. Various treatments are discussed, including 5-alpha-reductase inhibitors, corticosteroids, immunomodulators, hydroxychloroquine, isotretinoin, antibiotics, and pioglitazone, with combination therapy showing benefits in slowing disease progression. Finasteride and dutasteride are highlighted as particularly efficacious, stabilizing hair loss in 88% of patients in one study. However, the document also notes potential adverse side effects and the need for randomized controlled trials to further assess treatment efficacy. Other treatments like platelet-rich plasma (PRP) therapy and excimer laser therapy are mentioned, but more evidence is needed for their recommendation in FFA treatment. Hair transplantation showed mixed results, and the role of sunscreen in FFA pathogenesis remains controversial.
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