Hair loss can be a distressing experience, and for women, it can be particularly challenging. While many types of hair loss exist, frontal fibrosing alopecia (FFA) is a specific type that predominantly affects women. 

If you or someone you know is experiencing hair loss, it’s important to seek the right guidance and support; and to do so as early as possible. 

In this article, we will provide a comprehensive guide to FFA, including its causes, symptoms, and available treatment options. We hope that this information will help you better understand and manage hair loss and find the right solutions to restore your confidence and well-being.

What is Frontal Fibrosing Alopecia?

Frontal fibrosing alopecia (FFA) is a form of scarring alopecia that primarily affects women. In fact, only 1 – 2% of people diagnosed with FFA are men. It is characterised by the progressive recession of the frontal hairline, usually accompanied by the loss of eyebrow hair. 

Why are incidents of FFA becoming more common?

Frontal fibrosing alopecia (FFA) is a relatively new condition which was first described in 1994, and its true prevalence is not well established. However, there are several factors that may contribute to the increasing incidence of FFA in recent years:

  • Increased awareness: With the internet and social media, people can access more information about various medical conditions, including FFA. This increased awareness may lead to more people seeking a diagnosis for their hair loss and ultimately contribute to higher reported incidence rates.
  • Changes in diagnostic criteria: The diagnostic criteria for FFA have evolved over time, and some researchers argue that this has led to overdiagnosis of the condition. As more dermatologists and trichologists become familiar with FFA, they may be more likely to recognise it in their patients, leading to higher incidence rates.
  • Environmental factors: Some researchers have suggested that environmental factors, such as pollution or exposure to certain chemicals, may play a role in the development of FFA. However, more research is needed to fully understand the impact of these factors on the incidence of the condition.
  • Genetic factors: FFA may have a genetic component, and some researchers have suggested that changes in the prevalence of specific genetic variants or mutations may contribute to the increasing incidence of the condition. However, more research is needed to understand the role of genetics in FFA fully.

Overall, the reasons behind the increasing incidence of FFA need to be better understood, and more research is needed to understand the factors contributing to this condition’s development fully.

Causes of Frontal Fibrosing Alopecia

The exact cause of FFA is still unknown, but researchers believe that it may be an autoimmune disease. Studies have shown that FFA is associated with the infiltration of T lymphocytes, a type of white blood cell that plays a crucial role in the immune system. It is also thought that hormonal imbalances may contribute to the development of FFA, as the condition is more common in postmenopausal women. Sadly, we still have no definitive answer.

Symptoms of Frontal Fibrosing Alopecia

The most obvious symptom of FFA is the recession of the frontal hairline, which may progress slowly over time. Some people may also experience the loss of eyebrow hair or hair at the temples and notice individual or  “orphan hairs”  growing in front of the established hairline. In some cases, FFA may cause redness, scaling, and itching in the affected area.

Diagnosis of Frontal Fibrosing Alopecia

Diagnosing FFA can be challenging, as the symptoms can be similar to other forms of alopecia. A qualified trichologist or dermatologist will typically perform a physical examination and take a detailed medical history. They may also perform a scalp biopsy to confirm the diagnosis. A scalp biopsy involves taking a small sample of skin from the affected area and examining it under a microscope.

Treatment Options for Frontal Fibrosing Alopecia

There is currently no cure for FFA, but several treatment options can help slow down the progression of the condition and improve the appearance of the affected area. The choice of treatment will depend on the severity of the condition and the individual’s overall health.

Immunosuppressive therapy is often used to treat FFA, as it can help reduce the activity of the immune system and slow down the inflammation in the affected area. Corticosteroids may also be used to reduce inflammation, but they are typically only used in the early stages of the condition.

Here at the clinic, we use our anti-inflammatory treatment programme to manage inflammation on the scalp surface, with regular photos taken to measure the progression/stabilisation of the hairline.

Other treatment options for FFA include finasteride and minoxidil. These medications are commonly used to treat androgenetic alopecia, another form of hair loss. 

Hair transplantation may also be an option for people with advanced cases of FFA, but inflammation and recession of the hairline must be stable for at least 2 years before this can be considered otherwise, outcomes can be very poor.

Getting a Consultation from a Trichologist

If you are experiencing hair loss or have concerns about the health of your hair and scalp, it’s important to seek the advice of a qualified professional. At Fulham Scalp and Hair Clinic, our experienced trichologists can provide a comprehensive consultation to help determine the cause of your hair loss and recommend the most effective treatment options.

We understand that frontal fibrosing alopecia is currently a tricky condition to experience, and we would like to help you understand, treat, and manage your hair loss in the best possible way. Please get in touch with us.

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