Oral Isotretinoin Combined with Topical Clobetasol 0.05% and Tacrolimus 0.1% for the Treatment of Frontal Fibrosing Alopecia: A Randomized Controlled Trial

In a randomized controlled trial with 38 participants, the combination of oral isotretinoin with topical clobetasol 0.05% and tacrolimus 0.1% was found to be more effective in treating frontal fibrosing alopecia (FFA) than topical treatments alone. Out of the initial participants, 28 completed the study, which showed significant improvement in facial papules, frontotemporal hairline, and other FFA-related symptoms in the isotretinoin group after six months, with P-values <0.001 indicating strong statistical significance. The control group, which received only topical treatments, experienced worsening of symptoms. Side effects of isotretinoin included lip dryness, telogen effluvium, and malaise. The study concluded that isotretinoin combined with topical treatments could be a promising option for FFA, but noted limitations such as small sample size and loss to follow-up. Further research is needed to confirm these findings and determine the optimal dosage and treatment duration.