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Genetic and Rare Diseases Information Center (GARD)

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Frontal fibrosing alopecia

Other Names for this Disease
  • FFA
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What is frontal fibrosing alopecia?

How might frontal fibrosing alopecia be treated?

What is frontal fibrosing alopecia?

Frontal fibrosing alopecia (FFA) is a condition that causes hair loss (alopecia) on the scalp near the forehead, and may also cause hair loss in other areas such as the eyebrows or under the arms.[1]  FFA is thought to be a rare variant of lichen planus follicularis (also known as lichen planopilaris).[2]  Hair loss in FFA occurs when hair follicles, structures in the skin that make hair, are destroyed by inflammation caused by the body's immune system.[2]  Hair loss in FFA usually progresses slowly, and it may stabilize in some patients.[3]  This condition most commonly affects post-menopausal women, although it has also been reported in men and pre-menopausal women. [1][3]  Skin in the affected area usually looks normal but may show some mild scarring or appear somewhat pale.  There may also be some redness around hair follicles in the affected area due to active inflammation.[3]  Although it has been suggested that FFA may be due to hormonal changes or an autoimmune response, the exact cause of this condition is not yet known.[1]
Last updated: 8/19/2013

How might frontal fibrosing alopecia be treated?

Unfortunately, there is no proven cure for frontal fibrosing alopecia (FFA).[3]  However, because hair loss in frontal fibrosing alopecia (FFA) is thought to be caused by inflammation of hair follicles, treatment often involves using anti-inflammatory medications or ointments, such as corticosteroids or hydroxychloroquine (brand name Plaquenil), to reduce inflammation and suppress the body's immune system.[2]  One study of 36 individuals with FFA found a significant reduction in symptoms after six months of hydroxychloroquine treatment; however, they found minimal benefit to continuing hydroxychloroquine treatment after six months.[4]  Researchers continue to question whether or not treatment is effective, or if hair loss in FFA stops naturally.[5]
Last updated: 4/9/2012

  1. Arnold S. & Cooper S. Frontal fibrosing alopecia. Orphanet. May 2011; Accessed 4/9/2012.
  2. Frequently Asked Questions. Cicatricial Alopecia Research Foundation. September 2011; Accessed 8/9/2013.
  3. Frontal fibrosing alopecia. DermNet NZ. August 2011; Accessed 4/9/2012.
  4. Samrao A, Chew AL, Price V. Frontal fibrosing alopecia: a clinical review of 36 patients. British Journal of Dermatology. 2010; 163:1296-1300. Accessed 4/9/2012.
  5. Tan KT, Messenger AG. Frontal fibrosing alopecia: clinical presentations and prognosis. British Journal of Dermatology. 2009; 160:75-79. Accessed 4/9/2012.