Frontal Fibrosing Alopecia

Frontal fibrosing alopecia (FFA) is a type of hair loss caused by an imbalance in the immune system, which progressively and permanently damages the hair follicles. Over the past decade, the number of cases has increased significantly, making it the most common form of scarring autoimmune alopecia worldwide. It primarily affects women—accounting for over 90% of diagnosed cases—although men can also develop this condition in rare instances, and it can appear at any age.

Recognizing the Symptoms

Hair loss in frontal fibrosing alopecia typically begins along the front hairline, just above the forehead and around the temples. The affected areas often develop scarring, making the forehead appear larger over time. Progressive eyebrow thinning is common, and body hair may also be lost in various areas.

Some people experience itching, burning, redness, or flaking of the scalp. In addition, small bumps may appear on the facial skin, similar in appearance to mild acne. These are known as facial papules and are often associated with this condition.

How Is It Diagnosed?

Diagnosis is usually made during a specialist consultation using digital trichoscopy, a tool that magnifies and reveals specific patterns of inflammation and scarring on the scalp. In some cases, a skin biopsy is necessary to confirm the diagnosis through microscopic examination. Biopsies can also be used to contribute to research on this condition.

Can Frontal Fibrosing Alopecia Be Stopped?

The main goal in managing frontal fibrosing alopecia is to control the underlying inflammation that causes irreversible damage to hair roots. This requires regular follow-up with a trichology specialist, who will assess the progression of the condition using dedicated tools such as the Frontal Fibrosing Alopecia Severity Score (FFASS).

The most effective approaches involve personalized treatment plans, which may combine several methods depending on the individual case. These may help to stabilize the disease by strengthening the hair follicle, reducing inflammation, or improving skin appearance. Some in-office procedures can also target specific active areas of hair loss.

Are There Long-Term Cosmetic Solutions?

Yes. In carefully selected cases, hair transplantation can be a good option—especially for restoring the temples or eyebrows. However, the condition must be well-controlled before proceeding, as transplanted hair could be lost if the disease remains active.

Eyebrow micropigmentation or microblading is also a highly recommended option for women who have partially or completely lost their eyebrows. When performed by experienced professionals, the results can be remarkably natural.

For those with more advanced hair loss, FAS Hair Systems offer an effective, natural-looking solution. These custom-made systems integrate real hair and adapt perfectly to the area of alopecia. Other types of hair prostheses or hairpieces can also be tailored to frontal fibrosing alopecia, delivering excellent results. The key is to seek advice from professionals with experience in managing this condition.