Dr Paul Farrant

Overview

Dr Farrant is a consultant dermatologist with a particular expertise in hair loss and scalp disorders, and more than 25 years of clinical experience since qualifying into hospital practice in 1999. Dr Farrant's career has combined frontline NHS care, clinical leadership, clinical research and national guideline work, and is recognised internationally in the field of hair medicine.

Dr Farrant has led the dermatology department at Brighton and Sussex University Hospitals NHS Trust, served as President of the British Hair and Nail Society, helped write the British Association of Dermatologists' guidelines on alopecia areata, and contributed chapters on hair and scalp disease to the Rook Textbook of Dermatology. Dr Farrant is also a principal investigator on clinical trials of new treatments for alopecia areata and lichen planopilaris. Through Experts in Skin and Hair, that same experience is available to private patients.

Medical training

Dr Farrant built a broad foundation in general medicine before specialising. Pre-registration house officer posts in general surgery at Eastbourne District General Hospital and general medicine at Worthing District General Hospital (1999–2000) were followed by a senior house officer post in Accident & Emergency at St Thomas' Hospital, London.

Dr Farrant then trained in HIV medicine at the Elton John Unit in Brighton and completed a general medical rotation (2001–2002) across the Royal Sussex County Hospital, Brighton General Hospital and the Hurstwood Park Neurological Centre.

This early exposure to emergency care, infectious disease and neurology shaped a whole-patient approach to skin disease. Dr Farrant's first publications, in 2004, include a report of a granulomatous reaction as a feature of immune reconstitution syndrome. Later work on hair loss in inflammatory bowel disease, and on hair changes after chemotherapy and biologic treatment, reflects the same interest in links between the skin and general health.

Dermatology specialist training

Dr Farrant entered dermatology in 2002 as a senior house officer at the St John's Institute of Dermatology, St Thomas' Hospital, London. Specialist registrar training followed across several of the major centres in London and the south coast:

• St George's Hospital, Tooting, and King's College Hospital, London (2003–2004)
• Brighton and Sussex University Hospitals NHS Trust (2004–2006)
• Worthing and Southlands Hospitals (2006–2008)

Training was also a subject of Dr Farrant's early academic work. As the British Association of Dermatologists' national trainee representative from 2005 to 2007, Dr Farrant helped represent UK dermatology trainees, and went on to publish studies of trainees' views on the attributes of an effective trainer (British Journal of Dermatology, 2008) and on workplace assessment tools (British Journal of Dermatology, 2009).

Dr Farrant also served on the British Association of Dermatologists' Health Informatics subcommittee (2006–2011), and wrote papers during training on topics ranging from paediatric blistering disease to rare skin cancers and inherited skin conditions.

Consultant roles and clinical leadership

Dr Farrant's first consultant post was as a locum consultant dermatologist at King's College Hospital, London (2008–2009). Dr Farrant then became a consultant at Brighton and Sussex University Hospitals NHS Trust, where leadership responsibilities grew steadily:

• Clinical Lead for Dermatology, Brighton and Sussex University Hospitals (2012-2021). Responsible for the day-to-day running of the department and its medical staff, integration with community dermatology services, development of specialist services and the department's finances.
• Strategy lead for "The Elective Challenge" (2014). Led the Trust's strategy for planned-care pressures.
• Clinical Lead for the Sussex Transformation of Dermatology Services (2021). Helped redesign how dermatology care is delivered across Sussex.

Beyond the Trust, Dr Farrant has held national roles, including South East Regional Representative to both the British Association of Dermatologists and the Royal College of Physicians (2015–2018), and President of the British Hair and Nail Society (2012–2019).

Research and publications

Dr Farrant has authored or co-authored 46 peer-reviewed publications, most of them on hair and scalp disease, along with book chapters and conference abstracts. The work falls into four areas.

Guidelines and international consensus. Dr Farrant contributed to the British Association of Dermatologists' guidelines for alopecia areata (2012) and to its living guideline, updated in 2024 and 2025. Dr Farrant also took part in international expert exercises that have shaped how alopecia areata and frontal fibrosing alopecia are assessed and treated, including the Alopecia Areata Consensus of Experts (ACE) studies, the GRASS global registry consensus, the ASAMI severity index and the SOFFIA statement on frontal fibrosing alopecia. Dr Farrant is currently part of the European Alopecia Task Force, developing European expert consensus on managing all types of hair loss.

Setting the research agenda. Dr Farrant was part of the James Lind Alliance Priority Setting Partnerships for alopecia areata and for other types of hair loss, which brought patients and clinicians together to decide which research questions matter most.

Clinical and genetic research. Published work includes a UK descriptive study of 711 women with frontal fibrosing alopecia, a genome-wide association study identifying genetic susceptibility to the condition (Nature Communications, 2019), the genetic basis of uncombable hair syndrome (American Journal of Human Genetics, 2016; JAMA Dermatology, 2022), links between facial skincare products and frontal fibrosing alopecia in men, hair loss in inflammatory bowel disease, and guidance on standardised hair loss photography. Dr Farrant also took part in the UK Dermatology Clinical Trials Network's STOP GAP trial in pyoderma gangrenosum (BMJ, 2015).

Clinical trials. Dr Farrant has been principal investigator on trials of new treatments for alopecia areata, including oral JAK inhibitors (ritlecitinib, including the ALLEGRO programme, and upadacitinib) and topical dithranol, and on a current trial of brepocitinib in lichen planopilaris. Dr Farrant is UK Chief Investigator for a ritlecitinib trial in children aged 6 to 12.

Textbooks and teaching. Dr Farrant wrote the chapters on hair disorders and scalp dermatoses in the 9th edition of the Rook Textbook of Dermatology (2016), the scalp dermatoses chapter in the 10th edition (2022), and a chapter on the psychological aspects of hair disorders in Practical Psychodermatology (2014). Dr Farrant has lectured widely, including in the UK, Europe, Brazil and the Middle East, on topics from trichoscopy and pattern hair loss to alopecia areata and scarring alopecias. Dr Farrant sat on the organising committee of the World Congress for Hair Research in Edinburgh (2013), chaired a session at the 2015 congress in Miami, and chaired free papers and spoke at the 2022 congress in Melbourne.

Developing a dedicated hair loss and scalp disorder service

Hair and scalp conditions can be distressing and hard to treat, and they have historically been poorly served by general dermatology clinics. Over more than a decade Dr Farrant has built a dedicated service for them, in the NHS and in private practice.

In the NHS. A regional hair clinic has been part of the Brighton dermatology service for many years, and it was the subject of a presentation at the Wessex Dermatological Society in 2014. The clinic's research activity gives NHS patients access to new treatments. Dr Farrant is principal investigator at the Brighton site for trials in alopecia areata and lichen planopilaris, and national chief investigator for a trial in children.

Setting standards beyond Sussex. As President of the British Hair and Nail Society for seven years, Dr Farrant helped bring hair specialists together, and the clinical guidelines, consensus statements and teaching described above extend the same standards of care to clinicians across the UK and abroad.

In private practice. Through Experts in Skin and Hair, Dr Farrant offers private patients the same specialist approach: a careful diagnosis, including trichoscopy, and treatment based on current evidence. This approach is reflected in Dr Farrant's published work on objective severity assessment and standardised photography, which allows hair loss to be measured and followed over time. Conditions managed include alopecia areata, scarring alopecias such as frontal fibrosing alopecia and lichen planopilaris, pattern hair loss, hair shedding, childhood hair loss and inflammatory scalp disorders.