Excimer 308-nm laser for the treatment of frontal fibrosing alopecia: an observational study in 30 patients

Introduction: Frontal fibrosing alopecia (FFA) is a therapeutic challenge. There are few double-blind randomized controlled trials assessing the efficacy of available therapies. The 308-nm excimer laser currently has proven efficacy in treating skin conditions and a potential beneficial effect for the treatment of FFA. Method: A retrospective observational study was performed to evaluate the efficacy and safety of the 308-nm excimer laser for the treatment of FFA. TrichoScan® was performed at baseline and after 6 months of treatment. Clinical, standardized, and trichoscopic images were taken. Results: A total of 30 patients (90% women), with a mean age of 65.2 years, were included in the study. All patients had received prior treatments, and the excimer laser was added as an adjuvant treatment in cases with a poor response or a lack of satisfaction; however, no changes were made to their baseline treatment. Clinical response demonstrated stabilization in the recession of the frontotemporal hairline and band-like scarring area in 53.3% of the patients, improvement in 20%, and progression of alopecia in 26.7%. After 6 months of treatment, the majority of patients (83.3%) showed a one-grade improvement in the score of erythema, 6.7% experienced worsened erythema, and erythema reappeared after treatment in 3 patients. The majority of patients (70%) showed a one-grade improvement in the score of perifollicular hyperkeratosis, 10% showed a two-grade improvement, 16.7% remained stable, and hyperkeratosis reappeared after treatment in 1 patient. The only reported adverse effect was transient erythema in 4 patients. Conclusion: The excimer 308-nm laser might be a promising therapeutic option with a good safety profile for FFA as an adjuvant treatment in patients with symptomatic and progressive disease despite topical and oral therapies.