Background: Dutasteride has been proposed as an effective therapy for frontal fibrosing alopecia (FFA).
Objectives: We sought to describe the therapeutic response to dutasteride and the most effective dosage in FFA compared with other therapeutic options or no treatment.
Methods: This was a retrospective observational study including patients with FFA with a minimum follow-up of 12 months. Therapeutic response was evaluated according to the stabilization of the hairline recession.
Results: A total of 224 patients (222 females) with a median follow-up of 24 months (range 12-108 months) were included. The stabilization rate for the frontal, right, and left temporal regions after 12 months was 62%, 64%, and 62% in the dutasteride group (n = 148), 60%, 35%, and 35% with other systemic therapies (n = 20), and 30%, 41%, and 38% without systemic treatment (n = 56; P = .000, .006, and .006, respectively). Stabilization showed a statistically significant association with an increasing dose of dutasteride (88%, 91%, and 84% with a weekly treatment of 5 or 7 doses of 0.5 mg [n = 32], P < .005). Dutasteride was well tolerated in all patients.
Limitations: Limitations included the observational and retrospective design.
Conclusions: Oral dutasteride was the most effective therapy with a dose-dependent response for FFA in real clinical practice compared with other systemic therapies or no systemic treatment.
Keywords: 5-alpha-reductase inhibitors; cicatricial alopecia; finasteride; lichen planopilaris; scarring hair loss.
Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.