5-Alpha-Reductase Inhibitor Treatment for Frontal Fibrosing Alopecia:A Myth or Truth?

Frontal Fibrosing Alopecia (FFA) is a condition described in 1994 affect mainly postmenopausal women. It is the most common form of cicatricial alopecia considered as a follicular variant of lichen planopilaris [1]. It is believed that the main pathogenesis in this condition is related to dihydrotestosterone, a derivative converted from the testosterone through 5-Alpha- Reductase (5AR). Because inflammatory, autoimmune, and other organisms are thought to be associated with FFA, there is no one specific cause that can be acted on by 5AR inhibitors [2].Currently, the therapeutic approaches are limited and the patient outcomes are poor [1]. To date, most of the reports are case reports and observational studies [3]. No randomized controlled studies are evaluating the pharmacodynamic profiles of 5AR inhibitors for FFA. The long-term safety of 5AR inhibitors in women should also be considered.