Consensus Document on the Clinical Management of Frontal Fibrosing Alopecia: Recommendations From Spanish Working Group on Trichology and Onychology of the AEDV

The consensus document outlines updated guidelines for diagnosing and managing frontal fibrosing alopecia (FFA), a scarring alopecia mainly affecting postmenopausal women. Diagnosis is based on clinical and trichoscopic criteria, with biopsies for uncertain cases. Treatment involves topical and intralesional anti-inflammatory agents, oral 5-alpha-reductase inhibitors, and possibly hydroxychloroquine for severe inflammation. Injectable therapies like corticosteroids and platelet-rich plasma are recommended for moderate to severe cases, while hair transplantation is not preferred due to high follicle loss risk. Microblading is suggested for eyebrow alopecia. The document stresses the importance of patient communication about treatment expectations and considers the potential role of endocrine disruptors in disease onset. It also highlights the lack of approved targeted therapies and limited scientific evidence, with special considerations for treating men and premenopausal women.