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Diagnosis And Treatment Of Frontal Fibrosing Alopecia

Permanent hair loss can result from frontal fibrosing alopecia. If you start treatment early, you may be able to stop the hair loss from progressing, allowing you to keep the hair you have. Dermatologists refer to this as "stabilization."

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Here's what you need to know about diagnosing and treating Frontal fibrosing alopecia.

How Do Dermatologists Diagnose Frontal Fibrosing Alopecia?

  • To find out if you have this type of hair loss, your dermatologist will:
    • Examine your hairline, scalp, and eyebrows closely
    • Ask how long you’ve noticed the hair loss
    • Ask about symptoms like itch and pain and whether you have hair loss on any other part of your body
    • Talk with you about your health, medical conditions, and medications.

  • If your dermatologist suspects you have Frontal Fibrosing Alopecia, a scalp biopsy may be required. During an office visit, your dermatologist can perform this procedure while you are awake. Your dermatologist will numb a section of your scalp and remove a small amount of skin to perform a scalp biopsy.

  • The skin removed by your dermatologist will be examined under a microscope. This microscopic examination helps to rule out other causes of hair loss, such as traction alopecia.

  • FFA causes some people to develop small, raised spots on their faces that resemble pimples. If you have these bumps on your face, your dermatologist may recommend that one of them be removed. This will be examined under a microscope as well. This can assist you in receiving an accurate diagnosis.

  • If the results of the exam and biopsy show that you have FFA, your dermatologist will recommend treatment.

Dermatologists treat frontal fibrosing alopecia in a variety of ways

  • If you have FFA, treatment options include:
    • Stop the progression of hair loss, which may prevent permanent hair loss.
    • Relieve symptoms such as itching and pain.
  • Your dermatologist will tailor the treatment plan to your specific needs. 
  • Most treatment plans employ a combination of therapies because this yields the best results for patients.
  • FFA treatment may include one or more of the following:

    1. Finasteride or dutasteride

  • Including one of these medications in the treatment plan has been shown in studies to prevent further hair loss. 
  • In one study, either of these medications prevented further hair loss in all FFA patients. Almost half of the patients in this study experienced some hair regrowth.

    2. Topical Corticosteroids

  • Your dermatologist may inject this medication into your scalp to reduce the inflammation caused by FFA. Dermatologists may prescribe a corticosteroid that can be applied at home for some patients. Patients apply this medication to their scalp directly.
  • You would take one pill every day if this medication was part of your treatment plan. To continue seeing results, you must take the medication on a daily basis.

    3. Corticosteroids Injection

  • In one study, 10 of 11 patients who had lost their brows saw some regrowth after receiving corticosteroid injections. At three months, a few patients noticed regrowth of their brows. Within six months of starting the injections, ten of the eleven patients had some regrowth.
  • All of these patients with brow loss were also being treated for FFA with other medications.

    4. Hydroxychloroquine (Plaquenil)

  • In FFA patients, this medication may alleviate symptoms such as itch and pain. If you have FFA in its early stages, this medication may help you regrow some hair.
  • The effects of hydroxychloroquine on people vary according to studies. If this medication is prescribed as part of your treatment plan, you will take one pill once daily.
  • While this medication may benefit some people, one possible side effect is hair loss. Nausea, dizziness, vomiting, and loss of appetite are all possible side effects.

    5. Laser therapy

  • This treatment may help to reduce the swelling and itchiness caused by FFA on the scalp. Because it is a newer treatment option, more research is required. 
  • If laser therapy is an option for you, you can go to your dermatologist's office or a treatment center.

    6. Minoxidil 

  • Minoxidil is a well-known hair loss treatment. It is available without a prescription as a scalp application medication. Some patients will be prescribed minoxidil pills.
  • Patients with FFA have reported seeing results when they take finasteride (described above) daily and apply minoxidil to their scalp twice a day. It takes time for this combination to work. After 12 to 18 months, half of the eight patients who followed this treatment plan had no further hair loss.
  • You must continue to take a daily pill and apply minoxidil to see results. If you stop, your hair will fall out again.

    7. Other treatment options

  • Other medications or therapies than those listed above may be part of your treatment plan. 
  • Treatment depends on your needs and the location of your hair loss.


While this has not been proven, some studies suggest that your personal care products may have an effect on FFA. As a result, your dermatologist may advise you to use specific skin and hair care products.

Your dermatologist may also advise you on self-care measures. Self-care, when combined with treatment, can improve your overall results.


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