Increasing Utility of Finasteride for Frontal Fibrosing Alopecia

June 2015 in “ Journal of The American Academy of Dermatology ”

Melissa J. Danesh, Jenny E. Murase

finasteride frontal fibrosing alopecia 5a-reductase inhibitor minoxidil Propecia Rogaine

TLDR Finasteride helps treat frontal fibrosing alopecia, improving or stabilizing the condition in many patients.

Frontal fibrosing alopecia is a difficult condition to treat due to limited treatment options and lack of evidence for available agents. However, off-label use of finasteride, a type 2 5a-reductase inhibitor commonly used in men, has shown increasing efficacy for frontal fibrosing alopecia in women. A study involving 102 patients showed improvement in 47% and stabilization in 53% of patients. A combination strategy using finasteride and minoxidil in 8 patients halted progression of disease in 50% of patients after 12 to 18 months. The recommended starting dose of finasteride is 2.5 mg daily, with possible side effects including depression, headache, nausea, and hot flashes. If there is no improvement after 6 months, the dose of finasteride can be increased to 5 mg/d and minoxidil 2% to 5% can be added.

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Research cited in this study

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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 Diagnostic and Therapeutic Assessment of Frontal Fibrosing Alopecia

16 citations, January 2007 in “Actas dermo-sifiliográficas/Actas dermo-sifiliográficas”

The document concludes that there are no reliable treatments for frontal fibrosing alopecia, with only temporary benefits from current options.

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