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Antiandrogens improved frontal fibrosing alopecia symptoms
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Patients with severe forms of frontal fibrosing alopecia had eyelash loss, facial papules and body hair involvement that was stabilized or improved with antiandrogen treatment, according to recent study results.
Researchers in Spain conducted a retrospective multicenter study of 355 patients with frontal fibrosing alopecia (FFA; mean age, 61 years; 96.6% women). Recession of frontotemporal hairline was used to establish clinical severity.
Mean age of menopause was 49 years, with early menopause (age 45 years or younger) detected in 49 patients (14%). Forty-six women (13%) underwent hysterectomy, including 31 in the early menopause group.
One hundred thirty-six women (40%) and eight men (67%) had androgenetic alopecia (AGA). One hundred thirty-one patients (37%) had severe FFA, with multivariate analysis showing eyelash loss (OR=3.87; 95% CI, 1.74-8.59), facial papules (OR=2.96; 95% CI, 1.31-6.7) and body hair involvement (OR=2.26; 95% CI, 1.17-4.38) as independent factors. Mild forms of FFA were associated with eyebrow loss at initial presentation (OR=0.45; 95% CI, 0.26-0.78).
One hundred two patients were treated with finasteride (2.5-5 mg/day) and 18 patients received dutasteride (0.5 mg/week). One hundred eleven patients (31%) received 5-alpha-reductase inhibitors (5aRi), with improvement seen in 52 patients (47%) and stabilization in all others.
“Although [FFA] usually appears in postmenopausal women, premenopausal women or even men can be affected,” the researchers concluded. “Interestingly, we found a high rate of women with FFA presenting early menopause or having undergone hysterectomy, supporting a hormonal role in the pathogenesis of FFA. This hypothesis … was also supported by a good therapeutic response with oral 5aRi. The involvement of body hair or eyelashes and the presence of facial papules were associated with severe forms of FFA.”
Disclosure: The researchers report no relevant financial disclosures.
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