**4. Conclusions**

The best therapeutic option in FFA should include both topical and oral treatments. Five-alpha reductase inhibitors, especially dutasteride, have shown to be one of the most effective treatments in stopping hairline recession, and they should be used as first-line therapy in FFA patients. A topical anti-inflammatory drug should be added with a maintenance frequency regimen, that is, topical calcineurin inhibitors or topical corticosteroids, or even intralesional corticosteroids, depending on the degree of inflammation. When androgenetic alopecia is associated, adding topical or oral minoxidil may achieve better outcomes. In the case of eyebrow alopecia, especially in early stages, intralesional corticosteroids are recommended, although the use of oral minoxidil may also be helpful. In patients with facial papules, low-dose oral isotretinoin should be added to the treatment.

Regarding LPP, treatment commonly involves the use of high potency topical and/ or intralesional corticosteroids in cases with limited involvement and orally administered hydroxychloroquine in cases of progressive course or extensive cases. When therapy with hydroxychloroquine fails, methotrexate could be used as a second-line therapy, while mycophenolate mofetil and cyclosporine could be considered as third-line therapies. A short course of systemic steroids should be considered only in rapidly progressive and severe cases, acting as a bridge to the effect of longer-lasting drugs, such as methotrexate. Pioglitazone could be a promising and effective therapeutic option, although more evidence is needed to confirm its precise role in LPP management.
