Prognosis, Treatment, and Disease Outcomes in Frontal Fibrosing Alopecia: A Retrospective Review of 92 Cases

December 2017 in “ Journal of the American Academy of Dermatology ”

Lauren C. Strazzulla, Lorena Avila, Xiaoxue Li, Kristen Lo Sicco, Jerry Shapiro

frontal fibrosing alopecia intralesional corticosteroids topical agents systemic agents tacrolimus clobetasol betamethasone doxycycline tetracycline minocycline FFA corticosteroids topical treatments systemic treatments

TLDR Most patients with frontal fibrosing alopecia stabilized with treatment, especially younger ones, using intralesional corticosteroids and tacrolimus.

This retrospective review of 92 patients with frontal fibrosing alopecia (FFA) found that 70.7% of patients stabilized with treatment after an average of 10.4 months. The study identified that a younger age of onset was associated with a less severe disease course. Most patients (71.7%) were treated with intralesional corticosteroids combined with topical and systemic agents. Tacrolimus was found to be more effective in achieving stabilization within 3 months compared to clobetasol/betamethasone. Adverse effects were more common in patients treated with doxycycline, tetracycline, or minocycline. Limitations included the retrospective design and small sample size.

View this study on jaad.org →

Discuss this study in the Community →

Research cited in this study

5 / 5 results

research Frontal Fibrosing Alopecia: A Multicenter Review of 355 Patients

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

Most patients with frontal fibrosing alopecia are postmenopausal women, and treatments like finasteride and dutasteride can improve or stabilize the condition.

research Frontal Fibrosing Alopecia: To Treat or Not to Treat?

29 citations , July 2010 in “Journal of Cutaneous Medicine and Surgery”

Treatments for Frontal Fibrosing Alopecia have not been proven effective.

research Frontal Fibrosing Alopecia: Clinical Presentations and Prognosis

155 citations , September 2008 in “British journal of dermatology/British journal of dermatology, Supplement”

FFA is more common in postmenopausal women, can affect younger women, and may stabilize over time.

research A Case-Series of 29 Patients with Lichen Planopilaris: The Cleveland Clinic Foundation Experience on Evaluation, Diagnosis, and Treatment

113 citations , May 2007 in “Journal of the American Academy of Dermatology”

The study found that steroids and tetracycline helped treat active Lichen planopilaris, and hair transplants were good for later stages.

research Postmenopausal Frontal Fibrosing Alopecia

325 citations , June 1994 in “Archives of Dermatology”

Postmenopausal frontal fibrosing alopecia may be a unique condition linked to postmenopausal changes.

Related Community Posts Join

6 / 624 results

community Concerned About Asymmetrical Frontal Hair Loss and Recent Finasteride Use, Seeking Experiences

in General 154 upvotes 3 days ago

The user is experiencing asymmetrical hair loss at the frontal hairline and is concerned about potential conditions like frontal fibrosing alopecia. They have started using finasteride and pumpkin seed oil to address the issue.

community Fibrosing alopecia in a pattern distribution

in Research/Science 14 upvotes 1 year ago

A user has been experiencing hair loss for 4 years, with treatments like minoxidil, finasteride, and various supplements proving ineffective. They were diagnosed with fibrosing alopecia in a pattern distribution, a condition that may require a combination of anti-inflammatory and hair growth treatments.

community Can topical tretinoin only applied to face (not hairline) exacerbate hair loss?

in Chat 8 upvotes 1 week ago

Topical tretinoin applied to the face may exacerbate hair loss in some individuals, potentially triggering conditions like frontal fibrosing alopecia. Experiences vary, with some users reporting no impact on hair, while others experience significant hair loss.

community DUPA/Retrograde might not be DHT based...GET A BIOPSY QUICK or permanent Hair Loss!

in Research/Science 43 upvotes 11 months ago

DUPA and retrograde alopecia may not be solely DHT-based, and a biopsy is crucial for accurate diagnosis and treatment. Treatments mentioned include dutasteride, oral minoxidil, pioglitazone, clobetasol, calcipotriol, ketoconazole, and doxycycline, depending on the specific condition.

community If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

in Research 830 upvotes 1 year 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.

community Hairloss all over body and head

in Treatment 2 upvotes 5 days ago

A 25-year-old experiencing hair thinning all over the body and head, despite using minoxidil and having low vitamin D levels, is advised to seek a second opinion from a dermatologist specializing in hair loss. The likely diagnosis is diffuse alopecia areata, which may require treatment with a JAK inhibitor.