Update on Frontal Fibrosing Alopecia

This document provides an update on Frontal Fibrosing Alopecia (FFA), a type of hair loss that affects the frontal hairline and eyebrows. FFA is histologically similar to lichen planopilaris and is believed to be a clinical variant of this condition. No clinical trials have investigated the efficacy of treatments for FFA, but numerous drugs have been assessed in observational studies, with the best results reported for 5-alpha-reductase inhibitors and intralesional corticosteroids, followed by antimalarials and calcineurin inhibitors. The document also discusses the use of immunofluorescence and staining of elastic fibers to aid in the differential diagnosis of FFA from other types of alopecia. The most effective treatment for FFA is 5-a-reductase inhibitors, particularly when androgenetic alopecia (AGA) is also present. Intralesional corticosteroids may be indicated for pruritus, erythema, and hyperkeratosis, with particular emphasis on eyebrow involvement.