Frontal fibrosing alopecia (FFA) is a condition that causes hair loss on the front and sides of your scalp. Hair loss may also occur on eyebrows, eyelashes and other body parts. An autoimmune reaction, genetics or hormones may cause FFA. Healthcare providers diagnose FFA with a physical exam and skin biopsy.
The cause of FFA is unknown. It is thought that hormones may be partially responsible, as it typically affects post-menopausal women and can occur alongside genetic hair loss (also known as androgenetic or female pattern hair loss). However, blood tests for hormone levels don't usually show any abnormalities.
Anti-inflammatory medication is the most common treatment for most forms of scarring alopecia. Anti-inflammatory medication fights the inflammatory cells causing hair follicle destruction. You might take a pill, such as hydroxychloroquine, or receive a corticosteroid injection, such as triamcinolone acetonide.
Can stress cause frontal fibrosing alopecia? Stress may trigger FFA in people who already have a risk of developing it. In a study that enrolled 29 patients with FFA (28 women and 1 man), 15 patients said they had experienced a stressful event right before developing hair loss.
There isn't a cure for frontal fibrosing alopecia. But treatments can help to slow its progression. Your healthcare provider may suggest a combination of medications, including: Antibiotics, such as doxycycline or minocycline, to reduce inflammation.
Scarring alopecia (scalp discoid lupus erythematosus) can be the presenting manifestation of lupus in more than half of affected individuals. Diffuse nonscarring alopecia in lupus is usually responsive to treatment of the systemic disease.
Hair does not naturally grow in scarred skin where follicles have been destroyed. If scalp scars are small they may not cause any significant cosmetic problems. In some cases the person with scalp scarring can use hair styling to make the scars cosmetically invisible.
Usually, frontal fibrosing alopecia is slowly progressive although it seems to be self-limiting in most cases after several years. The hair line recedes on average of 1.8-2.6 cm. As it is a scarring alopecia, hair does not regrow unless treatment is instituted early in the process.
A dermatologist can tell you how to disguise FFA in a way that gives you a natural look. You may be able to apply a powder to your scalp that hides the hair loss. With the right technique, this can look completely natural. Your dermatologist may also recommend other options for hiding hair loss.
It is quite common, affecting approximately 50% of women by the age of 50. On the other hand, FFA is a rare, inflammatory, scarring alopecia that results in follicular destruction, occurring almost exclusively in postmenopausal women, with rare cases reported in young women and even fewer in men.
For most people with scarring alopecia the use of permament, semipermanent or temporary hair dyes is completely safe. I always advise that patients review with their dermatologist if they feel any change in their scalps whatsoever following the salon visit or home application.
Frontal fibrosing alopecia (FFA) tends to start slowly, often causing a thin band of balding skin that runs along the front and sides of the hairline. FFA can also cause hair loss elsewhere on the body. Anywhere you have hair, you may notice hair loss. Many people lose some (or all) of their eyebrows.
Only riboflavin, biotin, folate, and vitamin B12 deficiencies have been associated with hair loss.
For most people, the most obvious sign of hair follicle damage is hair loss. As your follicles become damaged, they may stop growing new hairs, resulting in a receding hairline, bald spot at your crown (the area at the top of your head) or diffuse thinning. Irritated skin.
A variety of factors are thought to cause alopecia areata (al-o-PEE-she-uh ar-e-A-tuh), possibly including severe stress. With alopecia areata, the body's immune system attacks the hair follicles — causing hair loss.
Scarring, or cicatricial alopecia, is an inflammatory condition that destroys hair follicles, causing scarring and permanent hair loss.
How does lupus affect hair? Many people with lupus have skin problems, like rashes or sores on the scalp, that can cause hair loss. Hair loss and thinning hair can also be side effects of certain medicines used to treat lupus, like steroids and immunosuppressives.
The scarring alopecia patches usually look a little different from alopecia areata in that the edges of the bald patches look more "ragged." The destruction of the hair follicle occurs below the skin surface so there may not be much to actually see on the scalp skin surface other than patchy hair loss.
Scarring alopecia begins as one or more permanent bald patches of on the scalp. These patches may remain discrete or coalesce to produce bigger bald areas on the scalp slowly progressing to near total alopecia. The bald patches on the skin have smooth and shiny appearance.
Androgenetic alopecia (AGA) is observed concomitantly with FFA in 16 to 57% of women [3,11,12,19,68,73] and in 67 to 83% of men [3,74]. An overlap of FFA, AGA, and frontal fibrosing in a pattern distribution (FAPD) has also been described [73].
The term end stage scarring alopecia is often tacked onto the report when the pathologist sees lots of scarring and little in the way of inflammation. To the pathologist, the finding of ESSA implies that hairs in the biopsy have been destroyed and there is not much left anymore to destroy.