The Treatment of Primary Cicatricial Alopecia Is Challenging

The treatment of primary cicatricial alopecia (PCA) is complex and requires careful consideration of available evidence. The paper critiques the claims made by Ezemma et al. regarding treatment options for PCA, highlighting a lack of evidence for the efficacy of gabapentin, narrowband UV-B phototherapy, and excimer laser in treating various forms of PCA. It emphasizes that pioglitazone and dutasteride should be reserved for specific types like lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) due to limited evidence for other forms. Additionally, the recommended dosages for rifampicin and clindamycin in treating folliculitis decalvans are corrected. The document underscores the importance of evidence-based treatment selection to improve patient outcomes.