What is the best treatment for frontal fibrosing alopecia?

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From the Research

The best treatment for frontal fibrosing alopecia (FFA) typically involves a combination of topical and systemic therapies, with 5-α-reductase inhibitors, intralesional steroids, and hydroxychloroquine having the highest level of evidence for treating FFA, as reported in the most recent study 1.

Treatment Options

  • First-line treatment usually includes topical minoxidil 5% solution applied once or twice daily to affected areas, along with potent topical corticosteroids such as clobetasol propionate 0.05% applied daily for several weeks, then tapered to maintenance use.
  • For more severe cases, oral medications are often necessary, with finasteride (2.5-5mg daily) or dutasteride (0.5mg daily) being effective options, especially in postmenopausal women, as supported by studies 2, 3.
  • Hydroxychloroquine (200-400mg daily) may be prescribed for its anti-inflammatory properties, with results typically seen after 6-12 months of treatment.
  • Intralesional corticosteroid injections (triamcinolone acetonide 5-10mg/ml) can be administered every 4-6 weeks for active, inflamed areas, as recommended in the literature 4, 5.

Important Considerations

  • It's essential to discontinue practices that may worsen the condition, such as tight hairstyles, chemical treatments, and excessive heat styling.
  • Treatment should begin as early as possible since hair loss from FFA is generally permanent, and therapy aims to halt progression rather than regrow lost hair.
  • Regular follow-up appointments every 3-6 months are recommended to monitor treatment response and adjust therapy as needed, as suggested in the studies 1, 5.

References

Research

Frontal fibrosing alopecia: efficacy of treatment modalities.

International journal of women's health, 2019

Research

Treatment of frontal fibrosing alopecia and lichen planopilaris: a systematic review.

Journal of the European Academy of Dermatology and Venereology : JEADV, 2013

Research

5-alpha-reductase inhibitor treatment for frontal fibrosing alopecia: an evidence-based treatment update.

Journal of the European Academy of Dermatology and Venereology : JEADV, 2018

Research

Frontal Fibrosing Alopecia: An Update on Pathogenesis, Diagnosis, and Treatment.

American journal of clinical dermatology, 2019

Research

Medical therapy for frontal fibrosing alopecia: A review and clinical approach.

Journal of the American Academy of Dermatology, 2019

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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