From the Guidelines
There is no direct association between frontal fibrosing alopecia (FFA) and androgenic alopecia (AGA) pathogenesis based on the provided evidence. The provided studies do not directly address the relationship between FFA and AGA. However, they discuss the role of micronutrients, particularly iron, in alopecia areata and androgenetic alopecia 1. Some key points from the studies include:
- Iron deficiency has been linked to hair loss conditions, including androgenetic alopecia, but the evidence is not conclusive 1.
- The relationship between iron deficiency and alopecia areata is also unclear, with some studies finding an association and others finding no difference in iron status between patients with alopecia areata and controls 1.
- Androgenetic alopecia is known to be influenced by hormonal factors, particularly androgens, which cause follicular miniaturization without scarring 1.
- The provided guidelines for the management of alopecia areata discuss the condition's chronic inflammatory nature, its impact on hair follicles and nails, and the variable prognosis, but do not directly address FFA or its relationship to AGA 1. Given the lack of direct evidence addressing the relationship between FFA and AGA, it is essential to approach each condition as distinct, with different pathogeneses, and manage them accordingly, considering the individual patient's characteristics and responses to treatment.
From the Research
Association between Frontal Fibrosing Alopecia (FFA) and Androgenetic Alopecia (Androgenic Alopecia) Pathogenesis
- There is evidence to suggest an association between FFA and androgenetic alopecia, as several studies have reported co-existence of the two conditions 2, 3, 4.
- A study published in 2019 found that 43.8% of patients with FFA also had androgenetic alopecia, and that treatment with 5α-reductase inhibitors was effective in stopping the progression of FFA 3.
- Another study published in 2016 found that 83% of men with FFA also had androgenetic alopecia or hair loss on eyebrows or extremities, suggesting a possible link between the two conditions 4.
- The frequent onset of FFA in post-menopausal women, similar patterning and co-existence with female pattern hair loss, together with a reportedly good response to 5α-reductase inhibitors, also suggest a role for sex steroid hormones in the pathogenesis of FFA 2.
- However, the exact nature of the association between FFA and androgenetic alopecia is not fully understood and requires further research 2, 5, 6.
Key Findings
- FFA is a primary patterned cicatricial alopecia with a complicated pathogenesis yet to be fully understood 2.
- The condition is characterized by the recession of the frontal, temporal, or frontotemporal hairline, and is often associated with eyebrow hair loss and other symptoms 6.
- Treatment options for FFA include 5α-reductase inhibitors, topical calcineurin inhibitors, hydroxychloroquine, peroxisome proliferator-activated receptor gamma agonists, and oral retinoid agents, among others 5, 6.
- Early diagnosis and prompt treatment are critical in managing FFA, as the condition can result in permanent hair loss if left untreated 6.