From the Research
The recommended dose of dutasteride for frontal fibrosing alopecia (FFA) is typically 0.5 mg taken orally, with a dose-dependent response showing higher efficacy at higher doses, such as 5 or 7 doses of 0.5 mg per week. This medication works by inhibiting both type I and type II 5-alpha reductase enzymes, which convert testosterone to dihydrotestosterone (DHT), a hormone implicated in the pathogenesis of FFA 1. Treatment duration is usually long-term, often continuing for at least 12-24 months before assessing full efficacy, with ongoing treatment necessary to maintain results. Dutasteride should be used as part of a comprehensive treatment approach that may include topical anti-inflammatories like corticosteroids or calcineurin inhibitors. Important considerations include that dutasteride is contraindicated in women who are pregnant or planning pregnancy due to potential feminization of male fetuses, and side effects may include decreased libido, erectile dysfunction, and gynecomastia. Regular follow-up appointments every 3-6 months are recommended to monitor treatment response and side effects. While dutasteride is not FDA-approved specifically for FFA, it is used off-label based on clinical experience showing efficacy in stabilizing this form of scarring alopecia, as supported by a systematic review and meta-analysis 2.
Some key points to consider when using dutasteride for FFA include:
- The dose-dependent response, with higher doses showing greater efficacy 1
- The importance of long-term treatment and ongoing monitoring 1, 2
- The potential side effects and contraindications, particularly in women of childbearing age 3, 4
- The use of dutasteride as part of a comprehensive treatment approach, including topical anti-inflammatories 1, 5
Overall, the use of dutasteride for FFA is supported by clinical experience and evidence from studies, although further research is needed to fully establish its efficacy and optimal dosing regimen 2, 4.