Therapeutic Updates on Lichen Planopilaris and Frontal Fibrosing Alopecia: A Systematic Review
September 2018
TLDR Antimalarial agents are effective for LPP, and intralesional steroids are effective for FFA.
This systematic review updated the treatment options for Lichen planopilaris (LPP) and Frontal Fibrosing Alopecia (FFA) by analyzing 38 studies published between March 2012 and June 2017. The review found that antimalarial agents and pioglitazone improved LPP in 73% and 71% of patients, respectively. Topical steroids and Tacrolimus/Pimecrolimus showed improvement and stabilization in about one-third and 50% of LPP cases, respectively. For FFA, antimalarial agents improved 68% of cases, intralesional steroids 83%, finasteride 100%, and dutasteride 95%. The review concluded that antimalarial agents were more effective than steroids for LPP, while intralesional steroids were more effective than antimalarial agents for FFA. However, the low quality and heterogeneity of the studies limited the ability to establish a definitive treatment protocol.