Frontal Fibrosing Alopecia: A Comprehensive Review With Recent Updates

January 2025 in “ Indian Journal of Dermatology ”

Shikha Verma, Anita Marak, Debopriya Paul

frontal fibrosing alopecia lymphocytic scarring alopecia androgenetic alopecia 5-alpha reductase inhibitors lichenoid lymphocytic infiltrate perifollicular fibrosis

Studysummary This review discusses the various factors implicated in the etiology of frontal fibrosing alopecia and notes the need for effective treatments, reporting no new clinical findings.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

Frontal fibrosing alopecia (FFA) is a primary lymphocytic scarring alopecia mainly affecting postmenopausal women, characterized by hairline recession. Its cause is unknown, but genetic, autoimmune, hormonal, and environmental factors are implicated. A study in New York City estimated its prevalence at 0.015%. FFA is associated with autoimmune diseases and often coexists with androgenetic alopecia. Clinical features include eyebrow and eyelash involvement and symptoms like pruritus. Histopathology shows lichenoid lymphocytic infiltrate and perifollicular fibrosis. Despite various treatments, including oral 5-α reductase inhibitors, managing FFA is challenging, and no definitive therapy exists. Further research is needed to understand its hormonal and genetic influences.

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