Meah, N. orcid.org/0000-0001-9466-6337, Li, J. orcid.org/0000-0001-7150-4052, Wall, D. orcid.org/0000-0002-0107-4488 et al. (62 more authors) (2025) Statement from the frontal fibrosing alopecia international expert alliance: SOFFIA 2024. Journal of the European Academy of Dermatology and Venereology. ISSN: 0926-9959
Abstract
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.