Statement from the frontal fibrosing alopecia international expert alliance: SOFFIA 2024

  • Meah, Nekma
  • Li, Jane
  • Wall, Dmitri
  • York, Katherine
  • Bhoyrul, Bevin
  • Bokhari, Laita
  • Coulthard, Lachlan
  • Asfour, Leila
  • Abraham, Leonardo Spagnol
  • Asz-Sigall, Daniel
  • Bergfeld, Wilma F.
  • Betz, Regina C.
  • Blume-Peytavi, Ulrike
  • Callender, Valerie
  • Chitreddy, Vijaya
  • Combalia, Andrea
  • Cotsarelis, George
  • Craiglow, Brittany
  • Dhurat, Rachita
  • Dlova, Ncoza
  • Donovan, Jeff
  • Doroshkevich, Andrei
  • Eisman, Samantha
  • Farrant, Paul
  • Gadzhigoroeva, Aida
  • Green, Jack
  • Grimalt, Ramon
  • Harries, Matthew
  • Hordinsky, Maria
  • Irvine, Alan D.
  • Jolliffe, Victoria
  • Kaiumov, Spartak
  • King, Brett
  • Kossard, Steven
  • Lee, Joyce
  • Lee, Won-Soo
  • Lortkipanidze, Nino
  • McMichael, Amy
  • Mesinkovska, Natasha Atanaskova
  • Messenger, Andrew
  • Mirmirani, Paradi
  • Olsen, Elise
  • Orlow, Seth J.
  • Ovcharenko, Yuliya
  • Piraccini, Bianca Maria
  • Pirmez, Rodrigo
  • Rakowska, Adriana
  • Reygagne, Pascal
  • Roberts, Janet
  • Rudnicka, Lidia
  • Saceda-Corralo, David
  • Shapiro, Jerry
  • Sharma, Pooja
  • Silyuk, Tatiana
  • Suchonwanit, Poonkiat
  • Takwale, Anita
  • Tosti, Antonella
  • Visser, W. I.
  • Vañó-Galván, Sergio
  • Vogt, Annika
  • Wade, Martin
  • Yip, Leona
  • Zlotogorski, Abraham
  • Zhou, Cheng
  • Sinclair, Rodney
Journal of the European Academy of Dermatology & Venereology Publish Ahead of Print, July 25, 2025. | DOI: 10.1111/jdv.20833

Background

As the incidence of frontal fibrosing alopecia (FFA) continues to rise, there is a need for an optimal treatment algorithm for FFA.

Objective

To produce an international consensus statement on the treatment modalities and prognostic indicators of FFA.

Methods

Sixty-nine hair experts from six continents were invited to participate in a three-round Delphi process. The final stage was held as a virtual meeting facilitated via Zoom. The consensus threshold was set at ≥66%.

Results

Of 365 questions, expert consensus was achieved in 204 (56%) questions following completion of the three rounds. Three additional questions were included at the final meeting. The category with the strongest consensus agreement was disease monitoring (9; 100%). Questions pertaining to physical therapies achieved the least category consensus (15; 40%), followed by systemic therapy (45; 43%).

Limitations

The study lacked sufficient representation from Africa and South America.

Conclusion

SOFFIA highlights areas of agreement and disagreement among experts. Robust research is warranted to provide evidence-based treatment recommendations.

Copyright © 2025 John Wiley & Sons, Ltd