Frontal Fibrosing Alopecia

What Is Frontal Fibrosing Alopecia?
Who Gets Frontal Fibrosing Alopecia?
Frontal Fibrosing Alopecia Symptoms
Frontal Fibrosing Alopecia Cause
Frontal Fibrosing Alopecia Treatment
Frontal Fibrosing Alopecia Prevention

What Is Frontal Fibrosing Alopecia?

Frontal fibrosing alopecia is a permanent condition that causes the hairline to recede. Hair loss may occur in other areas in addition to the scalp, such as the arms and legs. Loss of eyebrow hair is common. Frontal fibrosing alopecia also causes other changes, such as scalp scarring.

Who Gets Frontal Fibrosing Alopecia?

Frontal fibrosing alopecia is most common in women who have reached menopause. However, younger women, as well as men, can experience this form of hair loss. Kids don’t seem to develop frontal fibrosing alopecia.

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Frontal Fibrosing Alopecia Symptoms

A receding hairline is the most common feature of frontal fibrosing alopecia. Unlike male pattern baldness, those with frontal fibrosing alopecia experience other physical changes that can occur even before hair loss starts. For instance, some people develop pain or itching on the scalp. A rash of small bumps along the hairline, face, or scalp may appear.

When hair loss begins, it happens evenly along the hairline and temples. The newly exposed skin may look pale and shiny. In some people, the skin becomes slightly scarred.

Frontal fibrosing alopecia can cause hair loss in other parts of the body. Eyebrow thinning, or even complete loss of the eyebrows is common and often happens before the hairline recedes. Some patients lose eyelashes, too. Though frontal fibrosing alopecia is relatively uncommon in men, those who develop it may have trouble growing sideburns or beards due to patchy hair loss. Hair loss from frontal fibrosing alopecia can also occur on the arms and legs and in the pubic area.

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Frontal Fibrosing Alopecia Causes

The exact causes of frontal fibrosing alopecia are unknown, but scientists have several theories.

Autoimmunity

Typically, the immune system defends the body against germs and other microbial invaders. However, in autoimmune diseases, it attacks the body’s own tissues. Some doctors think frontal fibrosing alopecia occurs when the immune system attacks follicles, the tiny structures that produce strands of hair.

Hormonal Changes

Hormones may play a role in frontal fibrosing alopecia as women who have reached menopause, which involves dramatic shifts in hormone levels, make up the majority of those who develop the condition. However, how hormonal changes might cause frontal fibrosing alopecia is unknown.

Genetics

Some scientific evidence indicates that frontal fibrosing alopecia may run in families. A few studies investigating families and frontal fibrosing alopecia offer clues as to which genes may play a role, but more research is needed.

Allergies

Frontal fibrosing alopecia might be caused by an allergic reaction to cosmetics, hair dye, and even sunscreen. However, the current scientific evidence in inconclusive. Importantly, the skin-saving benefits of sunscreen are not in doubt, so keep slathering it on before heading outdoors (and use it indoors, too, if you’re sitting by a window).

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Frontal Fibrosing Alopecia Treatment

There’s no cure for frontal fibrosing alopecia, but a doctor can prescribe treatments that may slow down hair loss and, in some cases, promote hair regrowth. Often, a combination of treatments is used.

Whether any do-it-yourself treatments, such as taking vitamins, can help stop hair loss has yet to be thoroughly studied.

Corticosteroids

Dermatologists often use drugs called corticosteroids to lessen the damaging inflammation that occurs with frontal fibrosing alopecia. A doctor may inject corticosteroids into the scalp and/or give the patient a topical corticosteroid to apply at home.

Hydroxychloroquine

Hydroxychloroquine (Plaquenil) is a pill that can help reduce pain and itching. A small number of patients who use hydroxychloroquine may notice some hair regrowth.

Tetracyclines

Tetracyclines are antibiotics that also appear to relieve inflammation.

Hormone Blockers

Both men and women produce an enzyme, 5-alpha reductase, that converts testosterone into dihydrotestosterone (DHT). DHT plays a role in hair loss. Drugs that block 5-alpha reductase, called 5-alpha-reductase inhibitors (5-ARIs), are sometimes used to treat frontal fibrosing alopecia. They include finasteride (Propecia and Proscar) and dutasteride (Avodart). If you are pregnant or may become pregnant, these drugs are off limits.

Minoxidil

Minoxidil comes in liquid or foam and is applied directly to the affected area. It’s often more effective when combined with another treatment.

Laser Therapy

Laser therapy may help ease scalp itching and other symptoms. It may also produce new hair growth, but researchers have only studied a few patients using this approach.

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Frontal Fibrosing Alopecia Prevention

Since the cause of frontal fibrosing alopecia is unknown, it’s difficult to say whether any lifestyle habits can help prevent it. There’s no frontal fibrosing alopecia diet, but the Mediterranean diet — consuming lots of fruit, vegetables, olive oil, but little meat — seems to reduce body-wide inflammation. Preventing hair follicles from becoming inflamed could guard against frontal fibrosing alopecia, but this preventative measure has not been studied yet.

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