Statement from the frontal fibrosing alopecia international expert alliance: SOFFIA 2024

Abstract

Background: As the incidence of frontal fibrosing alopecia (FFA) continues to rise, there is a need for an optimal treatment algorithm for FFA.

Objectives: To produce an international consensus statement on the treatment modalities and prognostic indicators of FFA.

Methods: Sixty-nine hair experts from six continents were invited to participate in a three-round Delphi process. The final stage was held as a virtual meeting facilitated via Zoom. The consensus threshold was set at ≥66%.

Results: Of 365 questions, expert consensus was achieved in 204 (56%) questions following completion of the three rounds. Three additional questions were included at the final meeting. The category with the strongest consensus agreement was disease monitoring (9; 100%). Questions pertaining to physical therapies achieved the least category consensus (15; 40%), followed by systemic therapy (45; 43%).

Limitations: The study lacked sufficient representation from Africa and South America.

Conclusions: SOFFIA highlights areas of agreement and disagreement among experts. Robust research is warranted to provide evidence-based treatment recommendations.

Keywords: Delphi; consensus; frontal fibrosing alopecia; therapeutic guideline.