Hormonal Changes in LPP and FFA

The Clevland clinic performed a new study that  showed that hormone abnormalities can be common in lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA).

A proportion of patients with LPP were found to have "androgen excess" (increased levels of the male hormones). However there was a portion of patients with FFA that were shown to have "androgen deficiency." This did not prove to be true of everyone - but was a trend seen in a large proportion.

This study is surprising, especially when considering that antiandrogens are helpful in FFA. It may however provide insight into differences between LPP and FFA. More studies are needed. For now, I agree with the authors conclusions that hormone levels are important to order in women with these scarring alopecias.

Reference
Ranasinghe GC, et al.Prevalence of hormonal and endocrine dysfunction in patients with lichen planopilaris (LPP): A retrospective data analysis of 168 patients.  J Am Acad Dermatol. 2017.