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

Murad, Aizuri; Bergfeld, Wilma F.

doi:10.1111/jdv.14930

Cited by 24 publications

(26 citation statements)

References 22 publications

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“…5-α-reductase-inhibitors (5ARi) are amongst the most efficacious treatment options for FFA 25. Finasteride and dutasteride, well established in the treatment of androgenetic alopecia, are antiandrogens, and prevent the enzyme 5-α-reductase from converting testosterone into dihydrotestosterone 26.…”

Section: -α-Reductase Inhibitorsmentioning

confidence: 99%

“…Finasteride and dutasteride, well established in the treatment of androgenetic alopecia, are antiandrogens, and prevent the enzyme 5-α-reductase from converting testosterone into dihydrotestosterone 26. Finasteride, a type-II 5ARi, prevents this conversion in hair follicles, while dutasteride, a type I and II inhibitor, is less selective and inhibits conversion at hair follicles, and sweat and sebaceous glands 25,27…”

Section: -α-Reductase Inhibitorsmentioning

confidence: 99%

“…For the patient seeking to halt disease progression, especially those who present early in the disease course, a trial of 5ARis should be considered as they have an overall positive treatment outcome. However, it is important to note that 5ARis may have adverse sexual and psychiatric side effects, and may increase breast cancer risk, so they should be prescribed with caution 25. Furthermore, 5ARis are category X drugs and cannot be prescribed to women who are, or are planning to become, pregnant.…”

Section: -α-Reductase Inhibitorsmentioning

confidence: 99%

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Frontal fibrosing alopecia: efficacy of treatment modalities

Gamret¹,

Potluri²,

Krishnamurthy³

et al. 2019

IJWH

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Frontal fibrosing alopecia (FFA) is a primary cicatricial alopecia characterized by loss of follicular stem cells, fibrosis, and a receding frontotemporal hairline, with frequent loss of eyebrows, and less commonly, body hair involvement. Diagnosis is clinical and the disease most often affects postmenopausal women. Treatment is difficult with the goal of disease stabilization rather than hair regrowth due to the scarring nature of FFA. To date, there are no randomized controlled trials evaluating efficacy of treatments. Therefore, much of our knowledge is based on small retrospective studies. In this review, we highlight the various and most current treatment options for FFA, including 5-α-reductase inhibitors, intralesional steroids, hydroxychloroquine, topical steroids, topical calcineurin inhibitors, systemic retinoids, pioglitazone, oral antibiotics, minoxidil, excimer laser, and hair transplantation. Currently, 5-α-reductase inhibitors, intralesional steroids, and hydroxychloroquine have the highest level of evidence for treating FFA, while the remaining therapies have variable results and require further data to draw definitive conclusions.

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Section: -α-Reductase Inhibitorsmentioning

confidence: 99%

Section: -α-Reductase Inhibitorsmentioning

confidence: 99%

Section: -α-Reductase Inhibitorsmentioning

confidence: 99%

See 1 more Smart Citation

Frontal fibrosing alopecia: efficacy of treatment modalities

Gamret¹,

Potluri²,

Krishnamurthy³

et al. 2019

IJWH

View full text Add to dashboard Cite

show abstract

“…Teratogenicity, doubtful association with breast cancer, reduced libido and humor disturbances have been reported. 44 A retrospective multicenter study included 355 patients. 111 (31%) of them have taken finasteride 2.5-5.0 mg/day or dutasteride 0.5 mg/week with a mean time follow-up of 2.1 years.…”

Section: Treatmentmentioning

confidence: 99%

Frontal fibrosing alopecia: state of the art and future directions

Lascasas

Peixoto

Vedor³

2020

Int J Res Dermatol

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Frontal fibrosing alopecia (FFA) is a primary lymphocytic cicatricial alopecia, characterized by recession of frontotemporal hairline with frequent involvement of eyebrows and affecting occasionally other body areas. Entitled an emerging epidemic, due to its rising incidence, FFA etiology remains unclear without proven effective therapies. This study reviews relevant publications on FFA, regarding pathogenesis, clinical findings, histology along with treatment and prognosis. A bibliographic search was conducted in the main international databases, using the term ‘FFA’. Guidelines, observational studies, randomized controlled trials, reviews, systematic reviews and meta-analysis regardless of publication date, presented in English, Portuguese or Spanish, were included in this review. 50 publications were fully analysed. The majority of FFA cases were observed in postmenopausal women, although both men and women from younger ages can be victims. From an etiological point of view, immune-mediated hypothesis is widely spread, as stem cells localized in the bulge region of the follicle are destroyed by an inflammatory infiltrate. However, environmental factors raised interest, since sunscreen use was related to a bigger incidence of FFA. Three clinical patterns have been described. Yet the failure to use standardized assessment methods in addition to the absence of prospective studies evaluating available therapies, do not concede comparable data. Spontaneous stabilization of disease can occur, but regrowth was only seen in scarce cases. Outcomes from randomized controlled trials and prospective studies are missing to draw further understanding of FFA.

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“…The treatment of frontal fibrosing alopecia (FFA) is challenging. In a retrospective evidence‐based analysis of articles published between 2005 and 2017 to the topic of 5‐alpha‐reductase inhibitors (5‐ARI) and FFA, a moderate effect of 5‐ARI treatment was found in two studies with regard to disease stability or reduction in progression rate …”

Section: Hair Diseasementioning

confidence: 99%

Progress in Dermatology and Venereology – Editor's pick of the year 2018

Ring

2019

Acad Dermatol Venereol

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

Cited by 24 publications

References 22 publications

<p>Frontal fibrosing alopecia: efficacy of treatment modalities</p>

<p>Frontal fibrosing alopecia: efficacy of treatment modalities</p>

Frontal fibrosing alopecia: state of the art and future directions

Progress in Dermatology and Venereology – Editor's pick of the year 2018

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