Is There a Pathogenetic Link Between Frontal Fibrosing Alopecia, Androgenetic Alopecia, and Fibrosing Alopecia in a Pattern Distribution?

December 2017 in “ Journal of The European Academy of Dermatology and Venereology ”

Alexander C. Katoulis, K. Diamanti, Dimitrios Sgouros, Aikaterini I. Liakou, E. Bozi, Georgia Avgerinou, Ioannis Panayiotides, Dimitrios Rigopoulos

frontal fibrosing alopecia androgenetic alopecia fibrosing alopecia lichenoid reaction follicular destruction androgen-related antigenic stimulus immunogenetically susceptible scarring variant FFA AGA FAPD

TLDR Frontal fibrosing alopecia and androgenetic alopecia may be related, with a possible shared cause.

The authors of this letter to the editor report on the frequent coexistence of frontal fibrosing alopecia (FFA) and androgenetic alopecia (AGA) in women, and suggest that these conditions might be pathogenetically related. They conducted a study of 35 female patients diagnosed with FFA, and found that 57% of them also had AGA. They suggest that the lichenoid reaction leading to follicular destruction in patients with FFA might be pathogenetically related to the events underlying AGA, and that an androgen-related antigenic stimulus may initiate a lichenoid reaction in an immunogenetically susceptible individual. They also discuss the overlap of FFA, AGA, and fibrosing alopecia in a pattern distribution (FAPD) in some patients, and suggest that FFA could represent a scarring variant of AGA.

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Research cited in this study

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community Diffuse hair loss and scalp biopsies

in Research 692 upvotes 4 months ago

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

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in Research/Science 14 upvotes 9 months ago

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in Treatment 6 upvotes 1 month ago

The user experienced hair loss despite using Fin and Min for 12 years and switched to Dutasteride, RU58841, and Keto scalp serum, but shedding and itch persist. They are considering increasing Dutasteride to 2.5mg and questioning the necessity of a scalp biopsy, with mixed opinions on its usefulness.

community 1 and a half years on fin - hair is way worse.

in Finasteride/Dutasteride 9 upvotes 1 year ago

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community 9 months on Fin - no progress , should I get on Dutasteride?

in Chat 10 upvotes 1 month ago

The user has been using finasteride, minoxidil, and nizoral for hair loss but hasn't seen regrowth, only maintenance. They are considering switching to dutasteride, which is believed to be more effective, but are concerned about potential side effects.

community Actor Jacob Batalon, 26, has a receding hairline. I thought it was pretty cool to see a younger actor being successful, despite dealing with hair loss. His most well known role is Ned Leeds in the Marvel Cinematic Universe, and he is currently the CEO of Sex.

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