Patient handout · Hair Care
If you are losing your eyebrows, sideburns, or frontal hairline, you could have a dermatological condition called frontal fibrosing alopecia (FFA). Have you ever heard of it? Neither had doctors 30 years ago. Today, many doctors still mistakenly assume people face patterned baldness when they see frontotemporal hair loss.
Until the mid-90s, we didn’t recognize frontal fibrosing alopecia as a disorder. In 1994, a paper noted a pattern of hair loss on the frontal hairline and scalp in postmenopausal women. Doctors began to relate this hair loss to a hormone-triggered disorder, as the majority of the women were postmenopausal. Over the next ten years, this disease seemed to become more and more common. We think it has been around for hundreds of years but may not have been recognized.
How do you know if you are experiencing symptoms and signs of frontal fibrosing alopecia and not just hereditary hair loss?
The key is where the hair loss starts and the symptoms accompanying it. FFA includes frontal hair loss for over 99% of diagnosed patients and, for women, often begins with the loss of eyebrows.
Typically, other symptoms occur alongside these primary indicators.
Primary symptoms include:
Some women also lose their eyelashes, but that’s not as common.
Frontal Fibrosing Alopecia most commonly affects peri- or postmenopausal women in their 50-60s. We think that women who have undergone hysterectomies or experienced early menopause may be more susceptible to FFA, but the exact causes are unknown.
We don’t know exactly how common this disease is - there are not yet thorough population-based studies on the topic, and the incidence and prevalence may vary among countries.
Don’t be ashamed of your symptoms. Too many women are embarrassed by their hair loss, especially if they notice other unpleasant symptoms in more sensitive areas. It’s important to talk to your skin specialist if you have questions or show the signs above associated with FFA. Frontal fibrosing alopecia does not have to change your lifestyle or damage your self-image. Skin specialists are learning more about this disorder to develop effective frontal fibrosing alopecia treatments.
Skin specialists are still attempting to understand this disorder and best stop its effects.
Most skin specialists recommend a combination of treatment options to fight this type of hair loss.
Treatments include:
Currently, we don’t have one single frontal fibrosing alopecia treatment that’s consistently producing the results we want. Hair transplants are not always a viable solution to this hair loss due to the tissue scarring to which the new follicles are transplanted. In most hair transplant trials, transplants failed within four years in the cases of scarring alopecia. In recent research studies, we’re exploring the effects that particles in sunscreen and makeup may have on the hair follicle. We’re also trying to see if other hormonal, patient or environmental factors may contribute to this disorder.
While this disorder may be unique to our time, it may have been around for hundreds of years. If you look at famous paintings like the Mona Lisa, you’ll notice significant hair loss on the frontal scalp, temples, and eyebrows.
Similar patterns of hair loss are demonstrated throughout art and pop culture. The more we can understand the causes/triggers, natural progression, and other associations for FFA, the better we can treat it.
Treating frontal fibrosing alopecia is still a trial-and-error process for the clinician and patient. Still, hopefully, over time — with more experience and knowledge — we’ll develop better treatments to both stop hair loss and rejuvenate hair growth.
For now, there are more questions than answers. But the more people who become aware of FFA and its symptoms, the more opportunities we’ll have to find solutions for patients who experience its effects.
Appointments available at Hillside Medical Clinic in Victoria and Kensington Medical Clinic in Burnaby.