Effectiveness of dutasteride in a large series of patients with frontal fibrosing alopecia in real clinical practice

J Am Acad Dermatol. 2021 May;84(5):1285-1294. doi: 10.1016/j.jaad.2020.09.093. Epub 2020 Oct 7.


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.

Publication types

  • Observational Study

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Aged, 80 and over
  • Alopecia / drug therapy*
  • Alopecia / pathology
  • Dose-Response Relationship, Drug
  • Dutasteride / administration & dosage*
  • Female
  • Fibrosis
  • Follow-Up Studies
  • Forehead / pathology*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Scalp / drug effects
  • Scalp / pathology*
  • Treatment Outcome


  • Dutasteride