Oral Isotretinoin as the Most Effective Treatment in Folliculitis Decalvans: A Retrospective Comparison of Different Treatment Regimens in 28 Patients

    February 2015 in “ Journal of the European Academy of Dermatology and Venereology ”
    Julia K. Tietze, Markus V. Heppt, Anna von Preußen, U. Wolf, Thomas Ruzicka, Hans Wolff, Elke Sattler
    TLDR Oral isotretinoin is the most effective treatment for folliculitis decalvans.
    The study retrospectively compared the efficacy of different treatment regimens in 28 patients with folliculitis decalvans, a condition leading to scarring alopecia. The treatments analyzed included clindamycin and rifampicin, clarithromycin, dapsone, and isotretinoin. Clindamycin and rifampicin had the lowest success rate, with 80% of patients relapsing shortly after treatment. Clarithromycin and dapsone had better outcomes, with long-term remission rates of 33% and 43%, respectively. Isotretinoin was the most effective, achieving stable remission in 90% of patients during and up to two years post-treatment. The study concluded that the common use of antibiotics as first-line therapy should be reconsidered, and oral isotretinoin should be considered a valid alternative.
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