Frontal Fibrosing Alopecia: A Literature Review

Alopecia Frontal Fibrosante (AFF) is a primary scarring alopecia characterized by irreversible hair loss in the frontotemporal region, with increasing global incidence posing a challenge for dermatologists. Early diagnosis is crucial for effective treatment, as it allows intervention during potentially reversible stages. The etiology is not fully understood but may involve autoimmune, hormonal, and genetic factors, with chronic inflammation and perifollicular fibrosis leading to irreversible hair loss. Clinically, AFF presents with frontotemporal alopecia, possible eyebrow involvement, facial papules, hyperpigmentation, and symptoms like itching and pain. Diagnosis is confirmed via scalp biopsy, with trichoscopy aiding in monitoring. Treatment varies, including topical and intralesional corticosteroids, calcineurin inhibitors, 5-alpha reductase inhibitors, hydroxychloroquine, and isotretinoin, with hair transplantation as an option for severe cases. This literature review analyzed 16 articles from 2018 to 2024, aiming to describe clinical signs, symptoms, and trichoscopic findings to guide diagnosis and improve patient prognosis.