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

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

doi:10.1111/jdv.20833

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

Nekma Meah
, Jane Li
, Dmitri Wall
, Katherine York
, Bevin Bhoyrul
, Laita Bokhari
, Lachlan Coulthard
, Leila Asfour
, Leonardo Spagnol Abraham
, Daniel Asz-Sigall
, Wilma F. Bergfeld
, Regina C. Betz
, Ulrike Blume-Peytavi
, Valerie Callender
, Vijaya Chitreddy
, Andrea Combalia
, George Cotsarelis
, Brittany Craiglow
, Rachita Dhurat
, Ncoza Dlova

Jeff Donovan, Andrei Doroshkevich, Samantha Eisman, Paul Farrant, Aida Gadzhigoroeva, Jack Green, Ramon Grimalt, Matthew Harries, Maria Hordinsky, Alan D. Irvine, Victoria Jolliffe, Spartak Kaiumov, Brett King, Steven Kossard, Joyce Lee, Won Soo Lee, Nino Lortkipanidze, Amy McMichael, Natasha Atanaskova Mesinkovska, Andrew Messenger, Paradi Mirmirani, Elise Olsen, Seth J. Orlow, Yuliya Ovcharenko, Bianca Maria Piraccini, Rodrigo Pirmez, Adriana Rakowska, Pascal Reygagne, Janet Roberts, Lidia Rudnicka, David Saceda-Corralo, Jerry Shapiro, Pooja Sharma, Tatiana Silyuk, Poonkiat Suchonwanit, Anita Takwale, Antonella Tosti, W. I. Visser, Sergio Vañó-Galván, Annika Vogt, Martin Wade, Leona Yip, Abraham Zlotogorski, Cheng Zhou, Rodney Sinclair

Dermatology

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Background: As the incidence of frontal fibrosing alopecia (FFA) continues to rise, there is a need for an optimal treatment algorithm for FFA. Objectives: 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. Conclusions: SOFFIA highlights areas of agreement and disagreement among experts. Robust research is warranted to provide evidence-based treatment recommendations.

Original language	English (US)
Pages (from-to)	210-223
Number of pages	14
Journal	Journal of the European Academy of Dermatology and Venereology
Volume	40
Issue number	2
DOIs	https://doi.org/10.1111/jdv.20833
State	Published - Feb 2026

Bibliographical note

Publisher Copyright:
© 2025 The Author(s). Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

Keywords

Delphi
consensus
frontal fibrosing alopecia
therapeutic guideline

PubMed: MeSH publication types

Journal Article

Publisher link

10.1111/jdv.20833

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Meah, N., Li, J., Wall, D., York, K., Bhoyrul, B., Bokhari, L., Coulthard, L., Asfour, L., Abraham, L. S., Asz-Sigall, D., Bergfeld, W. F., Betz, R. C., Blume-Peytavi, U., Callender, V., Chitreddy, V., Combalia, A., Cotsarelis, G., Craiglow, B., Dhurat, R., ... Sinclair, R. (2026). Statement from the frontal fibrosing alopecia international expert alliance: SOFFIA 2024. Journal of the European Academy of Dermatology and Venereology, 40(2), 210-223. https://doi.org/10.1111/jdv.20833

Meah, N, Li, J, Wall, D, York, K, Bhoyrul, B, Bokhari, L, Coulthard, L, Asfour, L, Abraham, LS, Asz-Sigall, D, Bergfeld, WF, Betz, RC, Blume-Peytavi, U, Callender, V, Chitreddy, V, Combalia, A, Cotsarelis, G, Craiglow, B, Dhurat, R, Dlova, N, Donovan, J, Doroshkevich, A, Eisman, S, Farrant, P, Gadzhigoroeva, A, Green, J, Grimalt, R, Harries, M, Hordinsky, M, Irvine, AD, Jolliffe, V, Kaiumov, S, King, B, Kossard, S, Lee, J, Lee, WS, Lortkipanidze, N, McMichael, A, Atanaskova Mesinkovska, N, Messenger, A, Mirmirani, P, Olsen, E, Orlow, SJ, Ovcharenko, Y, Piraccini, BM, Pirmez, R, Rakowska, A, Reygagne, P, Roberts, J, Rudnicka, L, Saceda-Corralo, D, Shapiro, J, Sharma, P, Silyuk, T, Suchonwanit, P, Takwale, A, Tosti, A, Visser, WI, Vañó-Galván, S, Vogt, A, Wade, M, Yip, L, Zlotogorski, A, Zhou, C & Sinclair, R 2026, 'Statement from the frontal fibrosing alopecia international expert alliance: SOFFIA 2024', Journal of the European Academy of Dermatology and Venereology, vol. 40, no. 2, pp. 210-223. https://doi.org/10.1111/jdv.20833

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title = "Statement from the frontal fibrosing alopecia international expert alliance: SOFFIA 2024",

abstract = "Background: As the incidence of frontal fibrosing alopecia (FFA) continues to rise, there is a need for an optimal treatment algorithm for FFA. Objectives: 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. Conclusions: SOFFIA highlights areas of agreement and disagreement among experts. Robust research is warranted to provide evidence-based treatment recommendations.",

keywords = "Delphi, consensus, frontal fibrosing alopecia, therapeutic guideline",

author = "Nekma Meah and Jane Li and Dmitri Wall and Katherine York and Bevin Bhoyrul and Laita Bokhari and Lachlan Coulthard and Leila Asfour and Abraham, \{Leonardo Spagnol\} and Daniel Asz-Sigall and Bergfeld, \{Wilma F.\} and Betz, \{Regina C.\} and Ulrike Blume-Peytavi and Valerie Callender and Vijaya Chitreddy and Andrea Combalia and George Cotsarelis and Brittany Craiglow and Rachita Dhurat and Ncoza Dlova and Jeff Donovan and Andrei Doroshkevich and Samantha Eisman and Paul Farrant and Aida Gadzhigoroeva and Jack Green and Ramon Grimalt and Matthew Harries and Maria Hordinsky and Irvine, \{Alan D.\} and Victoria Jolliffe and Spartak Kaiumov and Brett King and Steven Kossard and Joyce Lee and Lee, \{Won Soo\} and Nino Lortkipanidze and Amy McMichael and \{Atanaskova Mesinkovska\}, Natasha and Andrew Messenger and Paradi Mirmirani and Elise Olsen and Orlow, \{Seth J.\} and Yuliya Ovcharenko and Piraccini, \{Bianca Maria\} and Rodrigo Pirmez and Adriana Rakowska and Pascal Reygagne and Janet Roberts and Lidia Rudnicka and David Saceda-Corralo and Jerry Shapiro and Pooja Sharma and Tatiana Silyuk and Poonkiat Suchonwanit and Anita Takwale and Antonella Tosti and Visser, \{W. I.\} and Sergio Va{\~n}{\'o}-Galv{\'a}n and Annika Vogt and Martin Wade and Leona Yip and Abraham Zlotogorski and Cheng Zhou and Rodney Sinclair",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). Journal of the European Academy of Dermatology and Venereology published by John Wiley \& Sons Ltd on behalf of European Academy of Dermatology and Venereology.",

year = "2026",

month = feb,

doi = "10.1111/jdv.20833",

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T1 - Statement from the frontal fibrosing alopecia international expert alliance

T2 - SOFFIA 2024

AU - Meah, Nekma

AU - Li, Jane

AU - Wall, Dmitri

AU - York, Katherine

AU - Bhoyrul, Bevin

AU - Bokhari, Laita

AU - Coulthard, Lachlan

AU - Asfour, Leila

AU - Abraham, Leonardo Spagnol

AU - Asz-Sigall, Daniel

AU - Bergfeld, Wilma F.

AU - Betz, Regina C.

AU - Blume-Peytavi, Ulrike

AU - Callender, Valerie

AU - Chitreddy, Vijaya

AU - Combalia, Andrea

AU - Cotsarelis, George

AU - Craiglow, Brittany

AU - Dhurat, Rachita

AU - Dlova, Ncoza

AU - Donovan, Jeff

AU - Doroshkevich, Andrei

AU - Eisman, Samantha

AU - Farrant, Paul

AU - Gadzhigoroeva, Aida

AU - Green, Jack

AU - Grimalt, Ramon

AU - Harries, Matthew

AU - Hordinsky, Maria

AU - Irvine, Alan D.

AU - Jolliffe, Victoria

AU - Kaiumov, Spartak

AU - King, Brett

AU - Kossard, Steven

AU - Lee, Joyce

AU - Lee, Won Soo

AU - Lortkipanidze, Nino

AU - McMichael, Amy

AU - Atanaskova Mesinkovska, Natasha

AU - Messenger, Andrew

AU - Mirmirani, Paradi

AU - Olsen, Elise

AU - Orlow, Seth J.

AU - Ovcharenko, Yuliya

AU - Piraccini, Bianca Maria

AU - Pirmez, Rodrigo

AU - Rakowska, Adriana

AU - Reygagne, Pascal

AU - Roberts, Janet

AU - Rudnicka, Lidia

AU - Saceda-Corralo, David

AU - Shapiro, Jerry

AU - Sharma, Pooja

AU - Silyuk, Tatiana

AU - Suchonwanit, Poonkiat

AU - Takwale, Anita

AU - Tosti, Antonella

AU - Visser, W. I.

AU - Vañó-Galván, Sergio

AU - Vogt, Annika

AU - Wade, Martin

AU - Yip, Leona

AU - Zlotogorski, Abraham

AU - Zhou, Cheng

AU - Sinclair, Rodney

N1 - Publisher Copyright: © 2025 The Author(s). Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

PY - 2026/2

Y1 - 2026/2

N2 - Background: As the incidence of frontal fibrosing alopecia (FFA) continues to rise, there is a need for an optimal treatment algorithm for FFA. Objectives: 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. Conclusions: SOFFIA highlights areas of agreement and disagreement among experts. Robust research is warranted to provide evidence-based treatment recommendations.

AB - Background: As the incidence of frontal fibrosing alopecia (FFA) continues to rise, there is a need for an optimal treatment algorithm for FFA. Objectives: 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. Conclusions: SOFFIA highlights areas of agreement and disagreement among experts. Robust research is warranted to provide evidence-based treatment recommendations.

KW - Delphi

KW - consensus

KW - frontal fibrosing alopecia

KW - therapeutic guideline

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U2 - 10.1111/jdv.20833

DO - 10.1111/jdv.20833

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AN - SCOPUS:105012477537

SN - 0926-9959

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JO - Journal of the European Academy of Dermatology and Venereology

JF - Journal of the European Academy of Dermatology and Venereology

IS - 2

ER -

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

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

Publisher link

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