Frontal Fibrosing Alopecia: Importance of Skin Color Changes

Importance of Skin Color Changes

Frontal fibrosing alopecia ("FFA" for short") is an autoimmune scarring hair loss condition that affects mostly peri menopausal and post menopausal women (most commonly). Individuals with

FFA experience loss of the frontal hairline and frequently eyebrow, eyelash and body hair loss as well.

The appearance of the scalp and the remaining hair follicles in the scalp are diagnostic in most cases. A biopsy is not always needed but is helpful in challenging cases.

The hair follicles are surrounded by redness (perifollicular erythema) and less commonly also scale (perifollicular scale). When one looks closely, a border can generally be seen between the unaffected skin of the forehead and the shiny, smooth atrophic skin of the area affected by FFA.

Many different types of treatments are available including topical steroids, steroid injections, topical calcineurin inhibitors, oral doxycycline, oral hydroxychloroquine, oral finasteride, oral dutasteride, oral methotrexate, oral isotretinoin, oral tofacitinib, oral mycophenolate. Benefits of lasers, including excimer and low level lasers continue to be explored.