Summary about Disease
Frontal fibrosing alopecia (FFA) is a type of scarring alopecia that primarily affects the frontal hairline and eyebrows. It is characterized by gradual recession of the hairline and loss of eyebrows, often accompanied by inflammation. FFA mainly affects postmenopausal women but can also occur in men and premenopausal women. The exact cause is unknown, and there is no cure, but treatments can help slow down the progression of the disease and manage symptoms.
Symptoms
Receding hairline: Gradual loss of hair along the front and sides of the scalp, creating a band-like pattern.
Eyebrow loss: Thinning or complete loss of eyebrows, usually starting at the lateral (outer) ends.
Pale skin: Smooth, pale or shiny skin in the affected area of the scalp.
Follicular papules: Small, raised bumps around hair follicles on the face or scalp.
Itching, burning, or tenderness: These sensations may occur on the scalp.
Loss of other body hair: Less commonly, loss of hair in the armpits, pubic area, or eyelashes.
Facial papules: Small flesh colored or reddish bumps on the face.
Veins that are visible on the forehead.
Causes
The exact cause of FFA is unknown, but several factors are believed to contribute:
Genetic Predisposition: There may be a genetic component, as some people with FFA have family members with autoimmune diseases.
Hormonal Factors: FFA is more common in postmenopausal women, suggesting a link to hormonal changes.
Immune System Dysfunction: FFA is considered an autoimmune disease, where the immune system mistakenly attacks hair follicles.
Environmental Factors: Sunscreens, moisturizers, and other topical agents have been investigated.
Other possibilities: Vitamin D deficiency has been suggested.
Medicine Used
4. Medicine used There is no cure for FFA, but treatments aim to slow down hair loss and relieve symptoms. Common medications include:
Topical Corticosteroids: Reduce inflammation on the scalp. (e.g., clobetasol propionate)
Topical Minoxidil: May stimulate hair growth in some cases.
Oral Medications:
Finasteride or Dutasteride: DHT blockers that can slow hair loss.
Hydroxychloroquine: An anti-malarial drug with anti-inflammatory properties.
Doxycycline or Tetracycline: Antibiotics with anti-inflammatory effects.
Steroids: Oral steroids.
Injections:
Corticosteroid Injections: Injected into the affected areas to reduce inflammation.
Other treatments:
Calcineurin inhibitors Topical tacrolimus or pimecrolimus.
Light and Laser Therapy: May stimulate hair growth and reduce inflammation.
Platelet Rich Plasma (PRP) Injections: Experimental treatment that uses the patient's own blood platelets to stimulate hair growth.
Is Communicable
No, frontal fibrosing alopecia is not communicable. It is not contagious and cannot be spread from person to person through contact.
Precautions
Sun Protection: Protect the scalp from sun exposure with hats, scarves, or sunscreen, as sun exposure can worsen inflammation.
Gentle Hair Care: Avoid harsh hair treatments, tight hairstyles, and excessive heat styling.
Healthy Lifestyle: Maintain a healthy diet, manage stress, and get enough sleep to support overall health and potentially reduce inflammation.
Regular Follow-up: See a dermatologist regularly to monitor the condition and adjust treatment as needed.
Avoid Potential Triggers: If you suspect certain hair products or environmental factors may be contributing to the condition, try to avoid them.
Consult a Dermatologist: Seek early diagnosis and treatment from a qualified dermatologist to manage the condition effectively.
How long does an outbreak last?
FFA is a chronic condition, and there are typically no "outbreaks" in the traditional sense. The disease is slowly progressive. Without treatment, hair loss will continue over years or decades. With treatment, it may slow or stabilize.
How is it diagnosed?
FFA is typically diagnosed through a combination of:
Clinical Examination: A dermatologist examines the scalp and hair loss pattern.
Patient History: The doctor takes a detailed history of symptoms, medical conditions, and family history.
Dermoscopy: A handheld device used to examine the scalp and hair follicles more closely.
Scalp Biopsy: A small sample of scalp tissue is removed and examined under a microscope to confirm the diagnosis and rule out other conditions.
Timeline of Symptoms
9. Timeline of symptoms The timeline of FFA symptoms can vary but generally follows a pattern:
Early Stages:
Gradual recession of the frontal hairline.
Thinning of eyebrows, starting at the outer edges.
Mild itching or burning on the scalp.
Progressive Stages:
Continued hairline recession.
More noticeable eyebrow loss.
Appearance of small bumps (follicular papules) on the face or scalp.
Smooth, pale skin in affected areas.
Late Stages:
Significant hairline recession.
Complete loss of eyebrows.
Potential loss of other body hair.
Scarring of the scalp in affected areas.
Symptoms can stabilize at any stage with treatment.
Important Considerations
Early Diagnosis: Early diagnosis and treatment are crucial to slow the progression of FFA.
Individualized Treatment: Treatment plans should be tailored to the individual's specific symptoms and disease severity.
Ongoing Management: FFA is a chronic condition that requires ongoing monitoring and management.
Psychological Impact: FFA can have a significant psychological impact on individuals. Support groups or counseling may be helpful.
Research and Clinical Trials: Ongoing research is exploring new treatments and potential cures for FFA. Participating in clinical trials may be an option.
Differential Diagnosis: Because other hair loss conditions can mimic FFA, accurate diagnosis by a dermatologist is important.