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What is Frontal Fibrosing Alopecia?
Written by Medicover Team and Medically Reviewed by Dr Koppisetti Satya Naga Ravi Teja , Dermatologist
Frontal Fibrosing Alopecia (FFA) is a type of scarring hair loss that mainly affects the front and sides of the scalp. It leads to a gradually receding hairline and often causes eyebrow thinning or loss. This condition involves inflammation around hair follicles, resulting in permanent damage and reduced hair growth in the affected areas.
Frontal Fibrosing Alopecia vs. Androgenetic Alopecia
Differentiating between FFA and androgenetic alopecia is crucial for accurate diagnosis and treatment. Here are the main distinctions:
- Pattern of Hair Loss: FFA affects the frontal hairline and eyebrows, while androgenetic alopecia typically impacts the crown and temples.
- Inflammation and Scarring: FFA is characterised by inflammation and scarring, whereas androgenetic alopecia does not involve these features.
- Population Affected: FFA predominantly affects postmenopausal women, while androgenetic alopecia is common in both men and women of various ages.
Who Is Likely to Develop Frontal Fibrosing Alopecia?
Frontal fibrosing alopecia (FFA) is most commonly seen in women after menopause, typically over the age of 50. However, it can sometimes affect younger women, even in their early 20s. In some cases, women of African descent may notice signs earlier, often in their 40s. While it is far less common, men can also be affected by this condition.
Certain factors may increase the likelihood of developing FFA. These include having.
- A close relative with FFA
- Skin conditions like rosacea
- Thyroid disorders
- Type 2 diabetes
What's the Frequency of FFA Cases?
Though considered an uncommon condition, reports of FFA have been steadily rising in recent years across different parts of the world. Researchers are still working to understand why it's becoming more widespread.
What Are the Symptoms of Frontal Fibrosing Alopecia?
Frontal Fibrosing Alopecia (FFA) usually develops slowly and may go unnoticed at first. The most common sign is a gradually receding hairline, especially around the forehead and temples. Eyebrow thinning, often starting from the outer edge, is another early clue.
Early Signs You May Notice
- Hairline starts to thin or move back gradually
- Eyebrows begin to fade, usually from the outer edges
- Skin looks smooth and pale where hair has fallen out
- A feeling of itchiness or tightness in the affected areas
- Hair loss spreads to other areas, like the arms or underarms
What Causes Frontal Fibrosing Alopecia and Who's at Risk?
Frontal Fibrosing Alopecia (FFA) is a slow-moving hair loss condition that mostly affects the front of the scalp and eyebrows. While doctors don't yet know the exact cause, several factors are believed to play a role.
Possible Causes
- Hormonal changes: Many women develop FFA after menopause, hinting at a hormonal link.
- Autoimmune response: The body's immune system may attack hair follicles by mistake.
- Genetics: Some people may inherit a higher risk through family history.
- Chronic inflammation: Ongoing inflammation around hair follicles can lead to scarring and hair loss.
Risk Factors
- Age: Most common in women over 50.
- Menopause: Often appears after hormonal changes in midlife.
- Family history: Having a close relative with FFA can increase the risk.
- Medical conditions: Linked with thyroid disease, rosacea, and type 2 diabetes.
- Cosmetic use: Some studies suggest a possible connection with facial skincare products, but more research is needed.
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Get Second OpinionHow Is Frontal Fibrosing Alopecia Diagnosed?
Diagnosing Frontal Fibrosing Alopecia (FFA) usually starts with a close look at the scalp and hairline. Since this condition causes a slow and steady hair loss at the front of the head, it can sometimes be mistaken for regular ageing or other forms of hair loss.
- Scalp Check: A dermatologist will examine your scalp to look for signs of thinning, scarring, or redness.
- Eyebrow and Skin Changes: They also check if your eyebrows are thinning or if there are changes in nearby skin.
- Trichoscopy: This is a special tool that gives a detailed view of the scalp and hair roots to spot early signs of FFA.
- Scalp Biopsy: If needed, a small skin sample is taken and tested to confirm the condition.
- Blood Tests: These may be done to check for hormone levels or autoimmune issues like thyroid problems.
What Are the Treatment Options for Frontal Fibrosing Alopecia?
Frontal Fibrosing Alopecia (FFA) is a slow, permanent form of hair loss. While it can't be cured, early treatment can help stop it from getting worse. The right treatment depends on how far the hair loss has progressed.
Common Ways to Treat FFA
- Anti-inflammatory creams and ointments: Doctors often start with topical steroids or other creams to reduce redness and swelling on the scalp.
- Oral medications: Medicines like hydroxychloroquineor finasteride may help slow down hair loss, especially if inflammation or hormones are involved.
- Scalp injections: In some cases, steroid injections are used directly in the affected areas to calm inflammation and protect hair follicles.
- Hair regrowth products: Minoxidil, a well-known hair growth lotion or pill, may help support any remaining hair.
- Laser therapy: Low-level laser treatments may improve scalp health and support other treatments. These are painless and done over time.
- Hair transplant: This is only considered when the condition has stopped progressing. It may help restore hair in areas that have fully lost growth.
When to See a Doctor?
Hair loss happens for many reasons, but if your hairline is steadily moving back or your eyebrows are thinning, it could be more than just ageing. Frontal Fibrosing Alopecia (FFA) often starts slowly, so early signs are easy to miss.
Signs You Shouldn't Ignore
- Receding hairline lasting more than 3 to 4 weeks
- Eyebrow loss, especially from the outer edges
- Itchy, red, or dry skin near the forehead
- Smooth or shiny scalp patches where hair has fallen out
Who Needs to Be Extra Careful?
- Women after menopause (usually over age 50)
- Anyone with a family history of hair loss or scarring alopecia
- People with thyroid problems, rosacea, or type 2 diabetes
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What Precautions Can Help Prevent Frontal Fibrosing Alopecia?
Frontal Fibrosing Alopecia (FFA) develops slowly and often goes unnoticed at first. While there's no guaranteed way to prevent it, a few simple steps can help protect your scalp and lower your risk.
Easy Precautions to Follow
- Be gentle with your hair and scalp: Avoid tight hairstyles like buns or braids that pull on the front hairline.
- Use mild skincare products: Try to limit the use of harsh facial creams or sunscreens near your hairline, especially if you notice irritation.
- Protect your scalp from the sun: Wear a hat outdoors or apply gentle sunscreen on exposed areas of your scalp.
- Watch for early signs: If your hairline starts to move back or your eyebrows begin to thin, don't ignore it.
- Visit your doctor regularly: If you have thyroid problems or a family history of hair loss, routine checkups can help catch symptoms early.
Possible Complications If Left Untreated
If FFA isn't treated in time, it may lead to.
- Permanent hairline loss
- Thinning or loss of eyebrows
- Scarring on the scalp
- Long-lasting itchiness or discomfort
- Emotional stress due to visible hair changes
In some cases, FFA is linked to thyroid disease or other immune-related conditions, so early treatment is important not just for your hair but your overall health.
Our Experience in Treating Frontal Fibrosing Alopecia
At Medicover Hospitals, we understand that hair loss, especially from Frontal Fibrosing Alopecia (FFA), can deeply affect your confidence and well-being. Our dermatology team has cared for many individuals facing this condition, offering not just medical treatment but also emotional support through every step.
We take time to listen, assess your symptoms carefully, and create a treatment plan that suits your needs. With a focus on early diagnosis, gentle therapies, and regular follow-ups, we help manage the condition and protect your remaining hair.
You're not just another case,we're here to walk with you, answer your questions, and guide you through a care process built on trust and understanding.
