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

    Emöke Rácz, Coen G. Gho, Peter W. Moorman, Vincent Noordhoek Hegt, H. A. Martino Neumann
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    TLDR No effective treatment for frontal fibrosing alopecia was found, but oral 5-alpha-reductase inhibitors had the best response; for lichen planopilaris, topical corticosteroids were commonly used but had a high relapse rate.
    The systematic review assessed the treatment efficacy for frontal fibrosing alopecia (FFA) and lichen planopilaris (LPP), including 114 FFA patients and 228 LPP patients. It found no effective treatment for FFA, with oral 5-alpha-reductase inhibitors (finasteride or dutasteride) showing the best response in 45% of 38 treated patients, while hydroxychloroquine was effective in 30% of 29 patients. Topical corticosteroids were ineffective for FFA. For LPP, topical corticosteroids were the primary treatment, with oral cyclosporine and systemic corticosteroids also used, though with a high relapse rate. The review suggested oral cyclosporine A as a potential treatment for future FFA studies.
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