Any advances in transplants for Frontal Fibrosing Alopecia?

Question

Being that FFA and LPP are "rare" types of hairloss, it seems treatment for these types of loss are being ignored/aren't a priority. It's a double whammy that transplant seems to not be an option as well, just wondering if there are any new cases, techniques, or studies on ways to get these to work? Are stem cell transplants an option? And have any of you had patients who finally reached the "burn out" stage? I don't see many (if any) sufferers on the internet speak of reaching "burn out".

Jae Pak, MD · Answer

Hair transplant surgery is generally contra indicated in Frontal Fibrosing Alopecia.  In rare instances hair transplant can be successful (on a individual basis).  Scalp MicroPigmentation (SMP) may be an option.

Marco Barusco, MD · Answer

FFA is not so rare. Sometimes it is just not diagnosed. There are medical and topical treatments for FFA and they can be effective in controlling this condition. Transplanting areas of FFA may be done if no active progression is seen for at least 2 years. However, we can't guarantee that the transplanted hairs will grow long term, and if they will grow to begin with. Some patients experience decent growth from transplants, only to lose those hairs after some time.I hope this is helpful to you.

Greg Williams, FRCS (Plast) · Answer

There is a great deal of on-going research on these dermatological scalp conditions which seem to be occurring more frequently. Unfortunately current treatment options don't work for everyone so it is important that you are managed by a doctor who specialises in inflammatory scalp disorders and can monitor your progress or stabilisation closely.FFA and LLP are relative contraindications to hair transplants. Certainly it would be foolish to do a hair transplant in an area of active disease and even in 'burned out' areas the growth may be disappointing and not sustained. Hopefully with greater understanding of the pathophysiology of the disease we will have better therapeutic options in the future.

Jeff Donovan, MD, PhD · Answer

FFA is challenging to treat. I'd strongly advise you see a dermatologist who specializes in hair loss. In the last year, more and more research has shown a clear benefit for finasteride and dutasteride in treating these conditions. These are off label indications for these drugs (and mainly used for male hair loss) but can be used for post menopausal women with FFA.Other treatments can also be considered for individuals with FFA, including hydroxychloroquine, methotrexate and steroid injections You need to see a dermatologist specializing in hair loss who treats many, many patients with FFA. That's the best route to go. Yes, hair transplants for FFA are challenging. Some work, some don't. Some work great and then lose hair down the road.  But yes, patients do burn out. The interesting thing about finasteride and dutasteride is some patients actually grow hair back which we would have said a few years ago was impossible. Granted it doesn't happened for everyone, but does happen for many.

Keith Durante, MD, FACS · Answer

This is a very complex situation and complete stabilization must be documented prior to consideration of any transplant procedure.I first attempt resolution with PRP injections in conjunction with a low laser therapy andtopical minoxidil. If after several months I see some follicular stimulation or at least no signs of inflammation, at this time I would consider a trial sample dose transplant prior to proceeding with a significant transplant procedure.The patient should be fully aware that there's considerable speculation regarding a high success rate however, pending a already successful sampled transplant area, the level of confidence could increase significantly at this time before moving ahead.

Michael Meshkin, MD - Account Suspended · Answer

In order for hair transplant  to be successful you first need to find the underlying cause for the hair loss.  If your diagnosis is fibrosing Alopecia,  since it is a autoimmune disease the transplanted hair most likely will not take.

William Rassman, MD (retired) · Answer

This is an autoimmune condition which is generally treated by a dermatologists. Hair transplants into the frontal area where the disease manifests with hair loss, often fails.  This diagnosis is not always evident on a clinical examination by the expert doctor so a biopsy should be done on any suspicion of its existence, Stem cell treatments are purely experimental at this stage. The concept of burnt out disease is a touchy one because what looks burnt out may not be in fact burnt out. I generally refer my patients with this condition to an appropriate expert in the field.The article I referenced below is an authoritative article in this field. There are some suggestions for treatment in the article.

Any advances in transplants for Frontal Fibrosing Alopecia?

Answers (7)

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