From the Research
The most effective treatment for folliculitis decalvans is oral isotretinoin, with a dose of ≥0.4 mg/kg/day for ≥3 months, as it has shown the highest success rate in achieving long-term remission and minimizing the likelihood of relapse 1.
Treatment Approach
The treatment of folliculitis decalvans should prioritize oral isotretinoin as the first-line therapy, given its superior efficacy compared to other treatment options.
- The dose of isotretinoin should be ≥0.4 mg/kg/day, and the treatment duration should be ≥3 months to achieve optimal results.
- Topical therapies, such as antiseptic washes and topical antibiotics, can be used concurrently to reduce bacterial load and promote healing.
- In cases where isotretinoin is not suitable or effective, alternative treatments such as antibiotics (e.g., tetracyclines, rifampin, and clindamycin) or immunosuppressants (e.g., cyclosporine) can be considered.
Rationale
The recommendation for oral isotretinoin as the first-line treatment for folliculitis decalvans is based on the study by 1, which demonstrated a high success rate of 82% in achieving long-term remission, with 66% of patients experiencing no relapse.
- This study provides the most recent and highest quality evidence for the treatment of folliculitis decalvans, making it the preferred choice for guiding clinical practice.
- The use of oral isotretinoin has been shown to be effective in reducing inflammation, preventing scarring, and promoting hair regrowth, ultimately improving the quality of life for patients with folliculitis decalvans.