Clinical Evaluation of Frontal Fibrosing Alopecia and Thyroid Dysfunction: A Retrospective Study

Background Frontal fibrosing alopecia is a scarring form of hair loss with a suspected but poorly understood link to thyroid disease. Evidence regarding this association remains limited and contradictory. Objective To describe the demographic and clinical profile of patients with frontal fibrosing alopecia and to investigate the prevalence of thyroid dysfunction in this population at Dhulikhel Hospital, Kathmandu University Hospital. Method A retrospective, cross-sectional analytical study was conducted on the medical records of 81 patients diagnosed with frontal fibrosing alopecia seen at the dermatology unit of Dhulikhel Hospital, Kathmandu University Hospital between May 2018 and May 2023. The study was approved by the Institutional Review Committee -Kathmandu University School of Medical Sciences with institutional Review committee number: 138/23. Associations between frontal fibrosing alopecia, thyroid dysfunction, and clinical features, including skincare and haircare practices, were analyzed using multivariable logistic regression using STATA version 14. Result The study included 81 participants with frontal fibrosing alopecia with a mean age of 64.5 ± 3.72 years. The average onset age for frontal fibrosing alopecia was 60.1 ± 3.26 years. Hypothyroidism was observed in 23 (28.4%) patients, and hyperthyroidism in 1 (1.23%). Additionally, no significant associations were found between frontal fibrosing alopecia and other factors such as sun protection use, moisturizing products, or other skincare practices. Conclusion Frontal fibrosing alopecia in postmenopausal women showed a high prevalence of hypothyroidism, but no independent association with thyroid dysfunction or common skincare and haircare practices. Thyroid screening may still be considered, and further studies are warranted to explore other etiological factors in Frontal fibrosing alopecia.