Frontal Fibrosing Alopecia
Frontal fibrosing alopecia is a type of scarring hair loss that typically affects the frontal hairline and temples.
It is considered a variant of lichen planopilaris and results in gradual, permanent hair loss due to inflammation and destruction of hair follicles.
The condition may also affect the eyebrows and areas around the ears, and can progress slowly over time.
At The London Skin and Hair Clinic, Consultant Dermatologists assess frontal fibrosing alopecia to confirm the diagnosis and determine the most appropriate management approach. Patients seeking a hair loss dermatologist in London can access specialist evaluation and care.
Frontal fibrosing alopecia is a variant of lichen planopilaris that affects the area where the hairline meets the front of the scalp
Affected hair follicles become inflamed and then destroyed
Some patients may also report itching, burning or pain around the hairline
Treatment will depend on whether inflammation and redness are present and may involve topical corticosteroids, immunosuppressive drugs and hydroxychloroquine
What causes Frontal Fibrosing Alopecia?
The exact cause of frontal fibrosing alopecia is not fully understood, but it is thought to involve an autoimmune process.
In this process:
- the immune system targets hair follicles
- inflammation develops around the follicles
- permanent damage and scarring can occur
Hormonal factors may also play a role, particularly given the association with menopause.
Who is at risk of Frontal Fibrosing Alopecia?
Frontal fibrosing alopecia most commonly affects:
- postmenopausal women
- individuals with a history of autoimmune conditions
- patients with lichen planopilaris
Although less common, it can also occur in men and younger women.
What are the symptoms of Frontal Fibrosing Alopecia?
The condition typically presents with progressive hairline recession.
Common symptoms include:
- gradual loss of hair along the frontal hairline
- thinning or loss of eyebrows
- hair loss around the temples or ears
- smooth, pale skin where hair has been lost
Some patients may also experience:
- itching
- burning
- tenderness in affected areas
In others, the condition may progress without noticeable symptoms.
Images of Frontal Fibrosing Alopecia
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How is Frontal Fibrosing Alopecia diagnosed?
A dermatologist will diagnose frontal fibrosing alopecia through clinical examination of the scalp and hairline.
Diagnosis may include:
- assessment of the pattern of hair loss
- dermatoscopic examination of the scalp
- review of medical history
In many cases, a scalp biopsy may be recommended to confirm the diagnosis and distinguish it from other types of hair loss.
How is Frontal Fibrosing Alopecia treated and managed?
Frontal fibrosing alopecia is a scarring condition, meaning that early diagnosis and treatment are important to help slow progression.
Management focuses on reducing inflammation and preserving existing hair.
Treatment options may include:
- topical or injected corticosteroids
- immunomodulating or anti-inflammatory medications
- systemic treatments in more advanced cases