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

April 2020 in “ Journal of Dermatological Treatment ”

Hamidreza Mahmoudi, Anahita Rostami, Soheil Tavakolpour, Ali Nili, Amir Teimourpour, Ali Salehi Farid, Robabeh Abedini, Mohammad K. Amini, Maryam Daneshpazhooh

oral isotretinoin topical clobetasol tacrolimus frontal fibrosing alopecia FFA facial papules frontotemporal hairline telogen effluvium Accutane Clobetasol Protopic

Studysummary This study found that combining oral isotretinoin with topical treatments was more effective than topical treatments alone for improving frontal fibrosing alopecia symptoms, despite some side effects. Our plain-language summary of this paper — not a Tressless recommendation.

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.

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Research cited in this study

18 / 18 results

research Frontal Fibrosing Alopecia: An Update on the Hypothesis of Pathogenesis and Treatment

38 citations , January 2019 in “International Journal of Women's Dermatology”

This review discusses potential therapeutic options for frontal fibrosing alopecia by exploring distinct signaling pathways and cellular players, but reports no new clinical findings and emphasizes the need for further trials.

research Lichen Planopilaris: Retrospective Study on the Characteristics and Treatment of 291 Patients

48 citations , November 2018 in “Journal of dermatological treatment”

In a study reviewing 291 patients with lichen planopilaris, findings revealed that women were more commonly affected than men, cyclosporine and methotrexate were most effective in achieving remission, and 5-alpha reductase inhibitors and systemic retinoids were particularly beneficial for frontal fibrosing alopecia.

research Algorithmic Approach to the Treatment of Frontal Fibrosing Alopecia: A Systematic Review

8 citations , October 2018 in “Journal of The American Academy of Dermatology”

This study evaluated treatments for frontal fibrosing alopecia and found hydroxychloroquine and 5a-reductase inhibitors to be most effective, with 70-72% of patients experiencing stabilization or improvement, but limitations in treatment consistency and assessment methods remain.

research Frontal Fibrosing Alopecia Presenting with Rapidly Spreading Facial Papules in a Premenopausal Woman: Case Report and Review

1 citations , August 2018 in “Journal of the American Academy of Dermatology”

A young woman developed facial bumps before hair loss, which is unusual for her condition.

research A Retrospective Analysis of Efficacy and Safety of Intralesional Triamcinolone Injections in the Treatment of Frontal Fibrosing Alopecia as Monotherapy or Concomitant Therapy

13 citations , January 2018 in “International Journal of Trichology”

In this study, intralesional triamcinolone acetonide injections were associated with halting the progression of frontal fibrosing alopecia in female patients and showed minimal adverse effects, but the efficacy as sole therapy remains unclear pending further trials.

research The Increasing Incidence of Frontal Fibrosing Alopecia: In Search of Triggering Factors

21 citations , October 2017 in “Journal of the European Academy of Dermatology and Venereology”

This study reports that variable environmental factors, including dietary habits, may contribute to the increasing incidence and diverse clinical presentations of frontal fibrosing alopecia.

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

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

In this study, researchers reported that oral isotretinoin effectively treated facial papules in frontal fibrosing alopecia, with histopathologic findings suggesting the involvement of elastic fibers and sebaceous glands in papule formation beyond perifollicular inflammation.

research Efficacy of Oral Retinoids in Treatment-Resistant Lichen Planopilaris

16 citations , October 2014 in “Journal of the American Academy of Dermatology”

This study found that oral retinoid therapy may provide clinical improvement in a small percentage of patients with treatment-resistant lichen planopilaris, although it is not commonly used as a first-line treatment.

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”

This study found that early intervention and treatment with intralesional triamcinolone acetonide may stabilize hairline recession in patients with frontal fibrosing alopecia, although further research is needed for definitive treatment guidelines.

research Frontal Fibrosing Alopecia: A Multicenter Review of 355 Patients

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

This study found that eyelash loss, facial papules, and body hair involvement were linked to severe frontal fibrosing alopecia, and antiandrogens were the most effective treatment.

research Treatment of Frontal Fibrosing Alopecia and Lichen Planopilaris

20 citations , January 2014 in “Journal of the European Academy of Dermatology and Venereology”

This article includes no new results; it discusses ongoing treatment approaches for frontal fibrosing alopecia and lichen planopilaris.

research Treatment of Frontal Fibrosing Alopecia and Lichen Planopilaris: A Systematic Review

117 citations , March 2013 in “Journal of the European Academy of Dermatology and Venereology”

This study reported that while no effective treatment exists for frontal fibrosing alopecia, oral 5-alpha-reductase inhibitors showed the most promise, inducing a good clinical response in 45% of patients.

research Frontal Fibrosing Alopecia: A Review of 60 Cases

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

This study reviewed clinical data from 60 patients with frontal fibrosing alopecia and found increasing prevalence and generally poor response to treatment, with the cause remaining unclear.