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Steroid-Related Vascular Issues in Frontal Fibrosing Alopecia Patients


The form of scarring hair loss known as Frontal Fibrosing Alopecia (FFA) currently has no truly safe, tolerable and effective treatments.

Because of this, it is not something we treat here at Belgravia, however, one option some patients are offered elsewhere is corticosteroid therapy. This involves a topical steroid solution being applied into the frontal hairline region, where the hairline has become bald with a thick band of pale skin visible, due to the inflammation associated with FFA.

Vascular issues from long-term FFA corticosteroid use

An Example of Frontal Fibrosing Alopecia which Causes a Receding Hairline in Women

An Example of Frontal Fibrosing Alopecia which Causes a Receding Hairline in Women

Researchers found that chronic corticosteroid use for FFA can result in vascular changes, which may cause difficulty in assessing the level of inflammation present in those with the condition.

Findings published in the Journal of the American Academy of Dermatology in May 2018 explained how a small-scale retrospective analysis of 19 FFA patients produced this conclusion.

A team with members from various institutions across Madrid, Spain – the Dermatology Department, Ramón y Cajal University Hospital, Grupo de Dermatología Pedro Jaén, and the Department of Medicine and Medical Specialties at the University of Alcalá – investigated patients’ trichoscopic images and medical records. They looked to establish whether the patients’ steroid use induced any changes in their hair loss.

Of the 19 patients, 8 did not use any form of treatment, whilst the remaining 11 were considered ‘chronic’ users of topical corticosteroids – meaning they had been using them daily for more than six months at the time the study data was taken.

The investigation found that chronic use of topical corticosteroids increased the presence of vascular structures and thin arborizing vessels in 95% of the 11 chronic users, versus 42% of those not receiving treatment, and 24% versus zero thick arborizing vessels and extravasated hemorrhages. Furthermore, an absence of perifollicular erythema and enhanced interfollicular vascular structures were also noted within the chronic topical steroid user group.

Whilst Frontal Fibrosing Alopecia can occur in men, it is predominantly found in women. As such, though the genders of the study participants are not publicly available, it is likely that they are all or mostly women.

On-going research

These findings, whilst interesting and certainly something for dermatologists dealing with cases of Frontal Fibrosing Alopecia to bear in mind, may form the basis of a larger scale investigation. This Spanish trial was extremely limited so broader-range research would be necessary to definitively determine whether this pattern was truly indicative of a general response.

For now, hope lies in the fact that there are currently alternative solutions being developed with a hope of finding a treatment for FFA, if not – what researchers looking into any hair loss condition hope to discover – a cure.

The Belgravia CentreThe Belgravia Centre

The Belgravia Centre is the leader in hair loss treatment in the UK, with two clinics based in Central London. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the UK or the rest of the world. View our Hair Loss Success Stories, which are the largest collection of such success stories in the world and demonstrate the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time for our hair loss helpline or to arrange a free consultation.

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