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Management of Folliculitis Decalvans: A Systematic Review.
Emily Sideris1, Danica Xie1, Jacqueline du Plessis2
1John Hunter Hospital Dermatology, Newcastle, New South Wales, Australia.
The Australasian Journal of Dermatology
|October 28, 2025
Summary
Folliculitis decalvans (FD) and Tufted Hair Folliculitis (THF) are difficult to treat scalp conditions. Combination therapies, including biologics and laser treatments, may offer better outcomes and longer duration of effect than systemic antibiotics alone.
Area of Science:
- Dermatology
- Trichology
- Systematic Review
Background:
- Folliculitis decalvans (FD) and Tufted Hair Folliculitis (THF) are chronic inflammatory scalp conditions causing scarring alopecia and impacting quality of life.
- Current treatment options for FD/THF are limited and often suboptimal, necessitating a review of emerging therapeutic strategies.
Conclusions:
- Combination therapy, integrating systemic antibiotics with topical, local, or other systemic agents, appears most effective for FD/THF.
- Biologic agents and laser therapy warrant further investigation for their significant role in FD/THF management.
- Low to very low GRADE evidence necessitates cautious interpretation and highlights the need for high-quality research.
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