What are your favorite topicals when treating scarring alopecia?

Fortunately, topicals can often be effective for scarring alopecia. In general, I tend to use high-potency topical steroids in combination with non-steroidal topicals, including topical JAK inhibitors (e.g., ruxolitinib, delgocintib, or compounded tofacitinib). Because the inflammatory process is relatively superficial along the hair follicle, these topicals can often be effective.

Topical steroids are still my go-to, though I also like topical tacrolimus often as first line. I have had success with roflumilast foam often, though not with everyone.

High-potency topical corticosteroids (class III-IV) are my preferred first-line topical treatment for most types of scarring alopecia, including central centrifugal cicatricial alopecia (CCCA), lichen planopilaris (LPP), discoid lupus erythematosus (DLE), folliculitis decalvans (FD), and dissecting cellulitis of the scalp (DCS). These agents target the inflammatory process that drives follicular destruction in scarring alopecias.

For FFA specifically, low- to mid-potency topical corticosteroids ...