FFA Patient Profile Analysis Based on Authors' Observations and Literature Review—An Original Survey

June 2025 in “ Journal of Clinical Medicine ”

Michał Owczarek, Magdalena Jałowska, Agnieszka Mariowska, Wiktoria Grochowska, Joanna Szyszkowska, الصديق حاجي, Maciej Spałek

frontal fibrosing alopecia FFA postmenopausal hypothyroidism β-blockers levothyroxine scalp itching scalp pain sunscreen thyroid hormone replacement beta-blockers thyroid medication

Studysummary This study reported that frontal fibrosing alopecia predominantly affects postmenopausal women and identified potential risk factors like frequent β-blocker use and sunscreen application, indicating the need for further research. Our plain-language summary of this paper — not a Tressless recommendation.

This study on frontal fibrosing alopecia (FFA) involved 19 women, primarily postmenopausal, with an average age of 60.58 years. It found that FFA often occurs after menopause, with a significant diagnostic delay of over 5 years. Common comorbidities included hypothyroidism (89.47%), and a notable number of participants had a history of reproductive or breast cancer (42.1%). The study observed a potential link between FFA and the use of β-blockers and levothyroxine. Scalp itching or pain was reported in 47.4% of cases, which may aid in diagnosis. Sunscreen use was frequent and suggested as a potential trigger, though its avoidance is not recommended due to cancer risk. The findings highlight the need for increased clinician awareness and further research into FFA's pathogenesis and risk factors.

View this study on mdpi.com →

Discuss this study in the Community →

Research cited in this study

35 / 35 results

research Enhanced Insights Into Frontal Fibrosing Alopecia: Advancements in Pathogenesis Understanding and Management Strategies

1 citations , May 2024 in “Dermatology and Therapy”

This review article examines the current understanding of frontal fibrosing alopecia, noting its prevalence in different demographics and the roles of genetic and environmental factors in its pathogenesis, while highlighting that treatment approaches remain varied and lack standardization.

research The Frontal Fibrosing Alopecia Treatment Dilemma

April 2024 in “Journal of clinical medicine”

This review discusses various therapeutic options for frontal fibrosing alopecia and highlights the need for more research, as existing data are largely retrospective and lack precise treatment guidelines.

research Frontal Fibrosing Alopecia and Reproductive Health: Assessing the Role of Sex Hormones in Disease Development

1 citations , January 2024 in “Journal of personalized medicine”

This narrative review suggests a strong association between abrupt hormonal imbalances and frontal fibrosing alopecia in women, especially related to reduced fertile years and certain hormonal therapies.

research Frontal Fibrosing Alopecia and Comorbidities in a Moroccan Population

April 2023 in “JAAD international”

This study observed that among a Moroccan population with frontal fibrosing alopecia, common comorbidities included lichen planus pigmentosus (36.8%), rosacea (28.9%), thyroid disorders (23.7%), and dyslipidemia (21.1%), highlighting potential relationships mediated by shared inflammatory or metabolic pathways.

research An Update on Alopecia and Its Association With Thyroid Autoimmune Diseases

January 2023 in “European endocrinology”

This review explores the association between alopecia and thyroid autoimmune disease, also highlighting a linked increased risk of thyroid cancer, but presents no new clinical findings.

research Frontal Fibrosing Alopecia: A Review of Disease Pathogenesis

2 citations , July 2022 in “Frontiers in Medicine”

This review discusses the current understanding of frontal fibrosing alopecia's pathogenesis, highlighting genetic susceptibility, immune response involvement, and possible links to steroid hormones, but reports no new clinical results.

research Lichen Planopilaris and Frontal Fibrosing Alopecia: Review and Update of Diagnostic and Therapeutic Features

13 citations , April 2022 in “Anais brasileiros de dermatologia/Anais Brasileiros de Dermatologia”

This comprehensive literature review highlighted that lichen planopilaris and frontal fibrosing alopecia, both primary scarring alopecias, are diagnosed via scalp biopsy, with no standardized treatments available, necessitating individualized therapeutic approaches based on patient characteristics.

research Effects of Chemical Straighteners on the Hair Shaft and Scalp

2 citations , January 2022 in “Anais brasileiros de dermatologia/Anais Brasileiros de Dermatologia”

This review discusses the effects of chemical hair straighteners and reports associated side effects like scalp inflammation and hair damage, noting the variability of findings and the need for further research.

research Potential Etiological Factors in Frontal Fibrosing Alopecia

January 2022 in “Przegla̧d dermatologiczny”

This article reviews potential causes of frontal fibrosing alopecia but does not provide new clinical findings.

research Frontal Fibrosing Alopecia: A Review and Practical Guide for Clinicians

August 2021 in “Annals of Agricultural and Environmental Medicine”

This review provides a detailed analysis of frontal fibrosing alopecia, focusing on its prevalence in postmenopausal Caucasian women, associated comorbidities, and potential autoimmune, genetic, hormonal, and environmental factors; it emphasizes the need for improved understanding to enhance diagnosis and treatment.

research Frontal Fibrosing Alopecia: A Review

23 citations , April 2021 in “Journal of Clinical Medicine”

This review compiles existing data on frontal fibrosing alopecia and highlights the promise of 5-alpha reductase inhibitors as a treatment option, while noting the need for clarity on its cause and progression.

research Facial Papules Are Early Sign of Frontal Fibrosing Alopecia: A Cross-Sectional Study

August 2020 in “Acta medica Iranica”

In this study, researchers found that facial papules may be early indicators of frontal fibrosing alopecia and lichen planopilaris, highlighting the importance of early recognition for diagnosis, especially in premenopausal women.

research Hair Transplantation in Frontal Fibrosing Alopecia and Lichen Planopilaris: A Systematic Review

16 citations , February 2020 in “The Laryngoscope”

This study found that hair transplantation is feasible in patients with lichen planopilaris and frontal fibrosing alopecia, but outcomes are generally less favorable compared to other causes and these diseases may also develop after the procedure.

research Frontal Fibrosing Alopecia: A Disease That Remains Enigmatic

9 citations , January 2020 in “Postepy Dermatologii I Alergologii”

This review discusses the enigmatic nature of frontal fibrosing alopecia and reports no clinical results; the authors stress the need for further research.

research Familial Frontal Fibrosing Alopecia in Two Male Families

6 citations , June 2019 in “International Journal of Dermatology”

This article discusses familial frontal fibrosing alopecia in two male families and reports no new clinical findings.

research Genome-Wide Association Study in Frontal Fibrosing Alopecia Identifies Four Susceptibility Loci Including HLA-B*07:02

115 citations , March 2019 in “Nature Communications”

This study identified significant genetic associations with frontal fibrosing alopecia at four genomic loci, suggesting it is a genetically predisposed immuno-inflammatory disorder influenced by the HLA-B*07: 02 allele.

research Frontal Fibrosing Alopecia: An Update on the Hypothesis of Pathogenesis and Treatment

38 citations , January 2019 in “International Journal of Women's Dermatology”

This review discusses potential therapeutic options for frontal fibrosing alopecia by exploring distinct signaling pathways and cellular players, but reports no new clinical findings and emphasizes the need for further trials.

research Frontal Fibrosing Alopecia: An Update on Pathogenesis, Diagnosis, and Treatment

61 citations , January 2019 in “American Journal of Clinical Dermatology”

This review discusses the potential causes and treatments for frontal fibrosing alopecia but reports no new clinical findings, highlighting the need for further research to understand its pathogenesis and develop validated treatments.

research Frontal Fibrosing Alopecia: A Case Series of 65 Patients Seen in a Single Italian Centre

23 citations , November 2018 in “Journal of the European Academy of Dermatology and Venereology”

This study observed that frontal fibrosing alopecia is increasingly diagnosed in Italian Caucasian females, often showing premenopausal onset and eyebrow alopecia as an early sign.

research Familial Frontal Fibrosing Alopecia: A Cross-Sectional Study of 20 Cases from Nine Families

8 citations , November 2018 in “Australasian Journal of Dermatology”

This study adds evidence suggesting a genetic component to frontal fibrosing alopecia, with daughters experiencing an earlier onset than their mothers, although the clinical pattern remains similar to non-familial cases.

research Single-Center Analysis of Patients with Frontal Fibrosing Alopecia: Evidence for Hypothyroidism and a Good Quality of Life

9 citations , October 2018 in “Journal of international medical research”

This study found no correlation between the extent of frontal fibrosing alopecia and quality of life, but observed a strong association with thyroid disease in affected women.

research Sunscreen and Facial Skincare Products in Frontal Fibrosing Alopecia: A Case-Control Study

26 citations , October 2018 in “British Journal of Dermatology”

This study found that high frequency use of sunscreen is associated with frontal fibrosing alopecia among women attending a specialist hair clinic in Australia.

research Alopecia Due to High Androgen Index Contraceptives

3 citations , July 2018 in “JAAPA”

This article reviews how to identify and manage androgenic alopecia caused by hormonal contraceptives but reports no new clinical findings.

research Lichen Planopilaris Caused by Wig Attachment: A Case of Koebner Phenomenon in Frontal Fibrosing Alopecia

7 citations , January 2018 in “International Journal of Trichology”

This case report documents the first instance of frontal fibrosing alopecia where lichen planopilaris developed at wig attachment sites, suggesting wigs may trigger the Koebner phenomenon in affected patients.

research Reply to: Updated Diagnostic Criteria for Frontal Fibrosing Alopecia

8 citations , December 2017 in “Journal of The American Academy of Dermatology”

This correspondence discusses the diagnostic criteria for frontal fibrosing alopecia but reports no new research findings, agreeing with many previously suggested criteria.

research Updated Diagnostic Criteria for Frontal Fibrosing Alopecia

30 citations , December 2017 in “Journal of The American Academy of Dermatology”

This correspondence discusses proposed updates to the diagnostic criteria for frontal fibrosing alopecia, emphasizing the importance of differentiating it from other types of alopecia.

research Frontal Fibrosing Alopecia: Update and Review of Challenges and Successes

17 citations , October 2017 in “Journal of Cutaneous Medicine and Surgery”

This review discusses the various treatment options for frontal fibrosing alopecia but reports no definitive results, as no treatment has proven effective in halting hairline recession or promoting hair growth.

research Frontal Fibrosing Alopecia Among Men: A Clinicopathologic Study of 7 Cases

41 citations , July 2017 in “Journal of The American Academy of Dermatology”

This study observed that frontal fibrosing alopecia also occurs in men, with clinical features and areas of involvement similar to those seen in women, but often affecting sideburns and facial hair.

research Hormonal Therapy in Female Pattern Hair Loss

21 citations , February 2017 in “International Journal of Women's Dermatology”

This review discusses the physiology and potential hormonal mechanisms involved in female pattern hair loss, as well as the current hormonal and hormone-modifying treatments available, but reports no new research findings.

research Prevalence of Hormonal and Endocrine Dysfunction in Patients with Lichen Planopilaris: A Retrospective Data Analysis of 168 Patients

44 citations , February 2017 in “Journal of the American Academy of Dermatology”

This study found that postmenopausal women with lichen planopilaris showed a high prevalence of androgen excess, while women with frontal fibrosing alopecia were often associated with androgen deficiency.

research DHEA and Frontal Fibrosing Alopecia: Molecular and Physiopathological Mechanisms

31 citations , December 2016 in “Anais Brasileiros de Dermatologia”

This review discusses the fibrogenic effects of TGFβ1, the regulatory role of PPAR, and the potential involvement of DHEA in frontal fibrosing alopecia, but reports no new clinical results.

research Frontal Fibrosing Alopecia: Reflections and Hypotheses on Etiology and Pathogenesis

68 citations , May 2016 in “Experimental dermatology”

This review discusses what is known about the pathobiology of frontal fibrosing alopecia and reports no new clinical findings, highlighting potential environmental and genetic factors in disease pathogenesis.

research Frontal Fibrosing Alopecia Treatment Options

20 citations , January 2016 in “Intractable & Rare Diseases Research”

In this clinical experience, treating frontal fibrosing alopecia with oral finasteride, hydroxychloroquine, tacrolimus, and excimer laser was associated with optimal results in patients with active inflammation.

research Frontal Fibrosing Alopecia: A Multicenter Review of 355 Patients

339 citations , February 2014 in “Journal of The American Academy of Dermatology”

This study found that eyelash loss, facial papules, and body hair involvement were linked to severe frontal fibrosing alopecia, and antiandrogens were the most effective treatment.

research Frontal Fibrosing Alopecia in Postmenopausal Women

179 citations , December 2004 in “Journal of The American Academy of Dermatology”

This study observed that frontal fibrosing alopecia in postmenopausal women involves selective follicular inflammation, and finasteride treatment may slow disease progression, suggesting a potential androgen-related component.