Frontal fibrosing alopecia (FFA) is a ‘primary cicatricial alopecia’ (encompassing a group of hair loss disorders in which the hair follicle is irreversibly damaged and replaced by fibrous tissue); this results in permanent hair loss along the frontal hairline.

Other areas of hair loss may include the top or back of the scalp, eyebrows, eyelashes, eyebrows and body hair.

FFA is most common in middle-aged or older women. Upon examination – the scalp shows alterations in the front hairline, including scattered isolated hairs or ‘lone hairs’. Thinning of the skin is often associated with FFA – resulting in more readily visible veins. The actual cause of FFA is currently unknown – although hormonal abnormalities may be present in some women.

Unfortunately, as with other scarring conditions, there is (as yet) no successful treatment for areas where scarring hair loss is already present, although topical applications (steroid creams) can help prevent the condition from progressing.

Common signs in Frontal Fibrosing Alopecia Diagnosis:

1. Eyebrow loss is common, often it is the first sign – although not always recognised

2. Both areas of the hairline in front of the ear have receded .

3.  Fine/short hairs are no longer present in the front hairline. Instead there are individual long hairs. There is often a faint ‘redness’ around the base of the hair.

4. Veins may be more visible (scalp/front hairline) and the skin itself often seems smoother and ‘paler’ in colour.

5. The average age for FFA is 46 – 66

Frontal fibrosing Alopecia is a complex condition, as with many conditions there is no ‘one way’ that it appears – it can present in many variations and diagnosis should be performed by a registered trichologist.



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