Study Probes Corticosteroid Frontal Fibrosing Alopecia Treatment

A new study into how effective intralesional corticosteroid treatment is for Frontal Fibrosing Alopecia is now underway in Catalonia.

According to the ClinicalTrials.gov website, researchers at the Universitat Internacional de Catalunya (International University of Catalonia) registered the trial in May ahead of the study's July start date. Findings are expected to be collated in December.

What is Frontal Fibrosing Alopecia?

Frontal Fibrosing Alopecia (FFA) is a rare hair loss condition which causes a receding hairline in women. It is very rarely seen in men although, according to researchers, in general 'the number of new cases of FFA appears to be increasing'.

FFA differs from the type of receding hairline seen in men with Male Pattern Baldness in that it is not genetic hair loss (although there may be genetic contributions) but a form of scarring alopecia.

It is thought to occur when a person's immune system turns against their hair follicles, attacking them. This leads to inflammation which can damage the follicles' stem cells and, once this happens, the hair not only falls out, but is unable to regrow.

Whilst Female Pattern Hair Loss can cause thinning hair around the temples and/or parting, women with FFA lose up to approximately eight centimetres of hair depth in a band around their hairline. Often some individual, isolated hairs within the recessed area may survive and in rare instances associated hair loss can also cause thinning or a complete loss of the eyebrows, eyelashes and abdomen hair. In these cases the associated hair loss may appear before the hairline recedes.

Study methods and objectives

Entitled a 'Prospective Double-blind, Placebo Controlled Study to Assess the Efficacy of Intralesional Corticoid on the Treatment of Frontal Fibrosing Alopecia', the study is headed up by Dr. Rubina Alves who is also involved in the current PRP treatment study.

Due to an absence of evidence-based studies of treatment for Frontal Fibrosing Alopecia, there is no set way for clinicians to treat the condition. The Catalan research team hopes to combat this by providing some clear, clinical data on the subject.

The six-month study aims to find out whether intralesional triamcinolone acetonide may be effective in stopping or slowing down the progression of FFA when compared to a placebo.

Each test subject has intralesional triamcinolone acetone injected into half their head 'in the active border of hairline', whilst the other half of their head is injected with a placebo (saline solution).

All participants being studied have been diagnosed with FFA, are aged 18 to 70 and none are pregnant. They have been divided into two groups, A and B. Group A has the right side of their head treated with the active drug, while the left side receives the placebo solution, whilst Group B receives the treatment but vice versa.

The intralesional triamcinolone acetone (40 mg/ml)l) of 0,1 mL/1cm, is administered along the frontal and frontoparietal hairline every four weeks. This means each participant will receive three rounds of these injections before their six month follow up appointment where final results will be taken.

Findings will be arrived at by measuring each individual's hair count based on the number of hairs per 0.65 cm2 and comparing the results from before and after treatment (baseline versus six month results). Standardised photographic images will help researchers to further evaluate participants' hair growth and, again, comparisons will be drawn by their baseline and 6 month images.

Current treatment options

Despite the condition being linked to hormonal changes, hormone therapy has been shown to be ineffective in treating Frontal Fibrosing Alopecia.

Given it is the inflammation damage which causes hair loss from FFA, current treatment options tend to focus on controlling this swelling.

Depending on the severity and duration of the FFA, sometimes oral steroids or anti-malarials can temporarily slow its progression. However, these treatments can have unpleasant side effects including depression, insomnia and skin rashes. A hair transplant can be an effective solution for women concerned about their receding from FFA but whether or not this surgery is suitable is decided on a case by case and surgeon by surgeon basis.

With information from the study due to be collated in December, we expect the report of the researchers' findings to be published in early 2016 and will bring you updates here as soon as they become available.