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 DlovaJeff 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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
JournalJournal of the European Academy of Dermatology and Venereology
DOIs
StateAccepted/In press - 2025

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

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