Welcome to the Evidence-Based Hair Podcast, hosted by Dr. Jeff Donovan, a leading dermatologist and hair loss specialist.

In this episode, Dr. Donovan takes a deep dive into frontal fibrosing alopecia (FFA), one of the most fascinating and challenging conditions in modern hair medicine. First described only a few decades ago, FFA has rapidly become one of the most common forms of scarring alopecia seen in hair clinics around the world.

Dr. Donovan explores what we have learned about FFA, including who develops it, why hair follicles are permanently lost, the role of genetics and the immune system, and the growing evidence that environmental factors may contribute to the disease. He also examines some of the most important recent discoveries that are changing how researchers think about FFA.

The episode tackles the major controversies surrounding the condition. Are sunscreens or facial products involved? Is FFA truly an autoimmune disease? Why do medications such as dutasteride and finasteride appear to help? And how should physicians determine whether treatment is actually working?

Along the way, Dr. Donovan separates what the evidence supports from what remains uncertain and explains why earlier recognition and careful monitoring are so important in this permanent form of hair loss.

 

HELPFUL REFERENCES

  • Krzesłowska WJ, Woźniacka A. The frontal fibrosing alopecia treatment dilemma. J Clin Med. 2024;13(7):2137.
  • Ezzat RZ, Alenezi S, Miteva M. Frontal fibrosing alopecia part II: etiopathogenesis and management. J Am Acad Dermatol. 2026;94(4):1075–85.
  • Verma S, Marak A, Paul D. Frontal fibrosing alopecia: a comprehensive review with recent updates. Indian J Dermatol. 2025;70:115.
  • Alenezi S, Ezzat RZ, Miteva M. Frontal fibrosing alopecia part I: diagnosis and clinical presentation. J Am Acad Dermatol. 2026;94(4):1059–72.
  • Bai JQA, Gupta S, Donovan J. Frontal fibrosing alopecia in males: a systematic review. JAAD Rev. 2025;6:66-68. doi:10.1016/j.jdrv.2025.08.002.
  • Landau M, Perez SM, Tosti A. Frontal fibrosing alopecia: a comprehensive guide for cosmetic dermatologists. Dermatol Ther (Heidelb). 2025;15(1):15–29.
  • Messenger AG, Asfour L, Harries M. Frontal fibrosing alopecia: an update. Am J Clin Dermatol. 2025;26(2):155–74.

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