Reassessing Frontal Fibrosing Alopecia

October 2008 in “ Expert Review of Dermatology ”

Dimitrios Rigopoulos, Efstathios Rallis, Stamatis Gregoriou, Andreas Katsambas

frontal fibrosing alopecia scarring alopecia frontoparietal hairline eyebrows lichen planopilaris oral prednisone chloroquine clinicopathologic correlation postmenopausal women FFA LPP prednisone

TLDR Frontal Fibrosing Alopecia is a slowly progressing hair loss condition, likely underdiagnosed, with ineffective treatments, needing more research to understand it fully.

The 2008 review on Frontal Fibrosing Alopecia (FFA) described it as a scarring alopecia that progresses slowly, mainly affecting the frontoparietal hairline and eyebrows, predominantly in women over 60. With only 117 cases reported, the condition was believed to be underdiagnosed. Histologically, FFA was similar to Lichen Planopilaris (LPP) and required clinicopathologic correlation for diagnosis. Treatments like oral prednisone or chloroquine were ineffective, and symptoms often worsened after stopping them. The review emphasized the need for more extensive research to understand FFA's characteristics, causes, and treatment, and questioned whether FFA should be considered a separate condition or a variant of LPP due to its unique presentation in postmenopausal women and poor response to treatment.

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Research cited in this study

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research Frontal Fibrosing Alopecia Versus Lichen Planopilaris: A Clinicopathological Study

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The conclusion is that FFA and LPP have similar scalp biopsy features, making them hard to distinguish histologically, and FFA may be a specific kind of scarring hair loss.

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Some postmenopausal women with frontal fibrosing alopecia stopped losing hair with finasteride treatment, hinting at a possible hormonal cause.

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research Post-Menopausal Frontal Fibrosing Alopecia

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The document concludes that post-menopausal frontal fibrosing alopecia is a poorly understood condition that does not respond well to common treatments.

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A premenopausal woman had hair loss and skin issues, treated with topical steroids.

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research Postmenopausal Frontal Fibrosing Alopecia: A Frontal Variant of Lichen Planopilaris

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Frontal fibrosing alopecia is a hair loss condition in postmenopausal women, similar to lichen planopilaris, with ineffective treatments.

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