Frontal Fibrosing Alopecia

At The Griffin Center of Hair Restoration and Research, we have been involved in the most advanced hair loss and hair restoration research for nearly 40 years.  In our last hair loss blog, we discussed some of the lesser known causes of hair loss, specifically scarring, or cicatricial alopecia, a form of alopecia characterized by permanent damage to the hair follicles.  There are several different forms of scarring alopecia that can result from a variety of different causes.  One form which has been occurring with increasing regularity is frontal fibrosing alopecia, a condition that affects the frontal hair line and eyebrows.

Frontal Fibrosing Alopecia, or FFA, is a rare form of hair loss that was only recently described when it was first identified in 1994 by Dr. Steven Kossard in six elderly Australian female patients.  Since then, several other cases have been documented and, over the past decade, the number of patients with this challenging disease has markedly increased.  Frontal fibrosing alopecia most commonly affects post-menopausal women between the ages of 40 and 80 years, with an average age of 67, but multiple cases of FFA in pre-menopausal women in their 30s and 40s have also been reported, as have a handful of cases where the condition occurs in men.  Research into frontal fibrosing alopecia is still ongoing and its cause remains largely unknown.

This slowly progressive condition is characterized mainly by its distinctive clinical pattern, which includes a symmetrical band of hair loss on the front and sides of the scalp along with, in most cases, a progressive loss of the eyebrows.  As the frontal hair line recedes, the edge may appear ragged or “moth-eaten” and single “lonely” hairs may persist in the bald areas.  This particular form of alopecia is currently believed to be a variant of lichen planopilaris, a type of cicatricial or scarring alopecia that causes smooth, white patches of scalp hair loss.  In both conditions, inflammation permanently destroys the sebaceous glands and the hair follicle, which is replaced with fibrotic scar tissue resulting in permanent hair loss.  The skin in the affected area usually looks normal but may be pale, shiny or mildly scarred without visible follicular openings.  At the margins of the bald areas, close inspection may show redness and scaling around hair follicles.  The two conditions differ in that lichen planopilaris causes hair loss in roughly circular patches all over the scalp, while frontal fibrosing alopecia affects a relatively straight band at the frontal hair line and includes eyebrow loss.

Frontal fibrosing alopecia can often occur alongside a much more common condition called androgenetic alopecia, also known as genetic pattern baldness, or may superficially resemble traction alopecia, a condition where prolonged use of tight hairstyles damages the hair follicles.  As a result, it is frequently misdiagnosed.  However these other, more common forms of hair loss usually do not permanently destroy the hair follicles and failure to properly treat this condition early can result in significant and permanent hair loss.  If caught early, however, the progression of this disease can be successfully slowed, which is just one of the reasons why, at The Griffin Center of Hair Restoration and Research, we believe that every case of alopecia requires a complete and comprehensive diagnosis.

If you have any questions about your individual hair loss or what form of treatment might be best for your specific concerns, please contact The Griffin Center to schedule a consultation.  Follow us on Facebook, Twitter, and Google+ to get the latest news in hair restoration and research.