There is a “new fad” of certain types of hair loss that tend to affect women primarily aftermenopausal, as if menopause was not accompanied by sufficient unwanted symptoms. If you notice that your hair loss starts at the front of your hairline, you may have frontal fibrotic alopecia (FFA). We asked experts about this condition that appears to be growing among postmenopausal women.
Featured experts
Jeffrey B. Wise, Maryland is a board certified facial plastic surgeon and hair repair expert in Wayne, New Jersey, and Dr. Deborah Longwill is a board certified dermatologist at Miami Xenya Popova.
What is frontal fibrotic alopecia?
“Frontial fibrotic alopecia is a type of hair loss that involves scarring, especially at the frontal hairline,” says Jeffrey B. Wise, a facial plastic surgeon and hair removal expert in New Jersey, and Jeffrey B. Wise, Maryland. “There’s a pattern like a band that often stretches from the temple to the middle of the forehead,” he explains. Dr. Deborah Longwill, a dermatologist in Miami, says it can also affect brows. “As time goes by, hair follicle destruction leads to permanent hair removal,” explains Dr. Longwill. Lead preparation chemist at rootist Kseniya Popova points out that this condition can be a very emotional experience.
What causes frontal fibrotic alopecia?
FFA can be caused by a number of factors, but no one is sure why someone is developing it, says Popova. “The exact cause is not fully understood, but we believe that the body’s immune system is an autoimmune process that attacks hair follicles,” says Dr. Longwill, who also points out that hormonal factors, genetics and environmental triggers play around with it. Dr. Wise adds that there are potential drugs that could lead to the condition as well.
Who is most commonly affected by frontal fibrotic alopecia?
FFA is most common in postmenopausal women, says Longwill. However, she points out that it can also sometimes appear in young women and men.
Is there a solution?
Hair loss associated with this condition is largely considered irreversible, says Popova. However, there are ways to slow down hair removal and stabilize the condition. “Early diagnosis and intervention are key to slowing progression. We usually use a combination of topical anti-inflammatory agents, oral drugs such as hydroxychloroquine or finasteride, and pathogenic corticosteroid injections to reduce inflammation,” says Longwill. Dr. Wise also says immunotherapy like topical or injectable corticosteroids might help.
“Support measures such as mild hair care and scalp sunscreen are also important. Regrowth is rare, but it can stop further losses and keep the remaining hair still,” says Longwill. “In my practice, hair transplants are frequently performed when the disease progresses steadily for more than 6-12 months.”
“There are such psychological factors associated with hair loss in visible parts of a woman’s face and head, so the best thing I recommend is to help manage the condition and support the rest of the hair.”