Oral Dutasteride Is a First-Line Treatment for Frontal Fibrosing Alopecia

Oral dutasteride is recommended as a first-line treatment for frontal fibrosing alopecia (FFA) due to its effectiveness in stabilizing the condition, as demonstrated in a systematic review and meta-analysis involving 366 patients, where 62.8% achieved stabilization. Despite the lack of double-blind randomized controlled trials, dutasteride shows the highest level of evidence among available treatments. Its potential mechanisms include antifibrotic properties, increased tissue oestradiol levels, and immunomodulatory effects. The treatment is considered safe for off-label use and can be combined with other therapies if needed.