Hair & Scalp
Frontal Fibrosing Alopecia
WHAT IS IT
Scarring hair loss along the hairline
HOW COMMON
Increasingly recognized, mainly postmenopausal women
CONTAGIOUS?
No — you cannot catch it or spread it
CURABLE?
Not curable; early treatment stabilizes it
What Is It?
Frontal fibrosing alopecia (FFA) is a form of scarring hair loss that slowly pushes back the frontal hairline, often with loss of the eyebrows. It's a type of lichen planopilaris and mostly affects women after menopause. Because the hair loss is scarring (permanent), the goal of treatment is to stop it from progressing.
Signs & Symptoms
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A slowly receding frontal (and sometimes side) hairline
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A pale, smooth band of scarred scalp where hair is lost
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Thinning or loss of the eyebrows
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Redness or scaling around remaining border hairs
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Sometimes small bumps on the face
Why Does It Happen?
FFA is caused by inflammation that targets and scars the hair follicles along the hairline, replacing them with scar tissue so hair can't regrow there. The exact trigger isn't known, but hormonal and immune factors are involved. Because lost hair in scarred areas usually can't be recovered, early treatment to protect remaining follicles is key. It is NOT contagious.
Treatment Options
Treatment aims to calm inflammation and halt progression — it stabilizes rather than reverses hair loss, so starting early matters. Combinations are common.
ANTI-INFLAMMATORY
Topical/injected steroids or calcineurin inhibitors to calm inflammation.
5-ALPHA-REDUCTASE INHIBITORS
Finasteride or dutasteride to help slow progression.
ADJUNCTS
Hydroxychloroquine, antibiotics, or low-dose oral minoxidil in some cases.
EYEBROW & COSMETIC CARE
Options to address eyebrow loss and camouflage.
Tips for Managing It at Home
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Seek care early — treatment protects the hair you still have
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Understand the goal is to stabilize, since scarred areas won't regrow
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Be gentle with the hairline; avoid tight, pulling styles
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Keep regular follow-up to monitor progression
When to Call Your Provider
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A receding hairline or thinning eyebrows (get assessed early)
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Redness, scaling, itching, or burning at the hairline
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Progression despite current treatment
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Distress about the changes
Sources & further reading
The information in this handout is based on general dermatology guidance from the reputable organizations below. These links are provided for patients who wish to read more from trusted sources.
American Academy of Dermatology (AAD). Frontal Fibrosing Alopecia. https://www.aad.org/public/diseases/hair-loss/types/frontal-fibrosing-alopecia
Canadian Dermatology Association (CDA). Alopecia. https://dermatology.ca/public-patients/diseases-conditions/hair-conditions/alopecia/
DermNet. Frontal Fibrosing Alopecia. https://dermnetnz.org/topics/frontal-fibrosing-alopecia
Mayo Clinic. Frontal Fibrosing Alopecia. https://www.mayoclinic.org/diseases-conditions/hair-loss/expert-answers/frontal-fibrosing-alopecia/faq-20485259
This handout is for general education and does not replace advice from your own provider. Always follow your provider’s specific instructions.
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