Frontal fibrosing alopecia (FFA) is a type of scarring alopecia characterized by a progressive recession of the hairline, predominantly affecting postmenopausal women. While the exact cause of FFA remains a mystery, it has become increasingly common since its first description in the early 1990s. This article explores the intricacies of frontal fibrosing alopecia, including its symptoms, causes, and the potential of treatments like minoxidil and finasteride.
Understanding Frontal Fibrosing Alopecia
Frontal fibrosing alopecia is considered a variant of lichen planopilaris, a condition where hair follicles are replaced by inflammatory scarring. FFA specifically affects the front of the scalp, resulting in a characteristic band of hair loss along the frontal hairline.
Symptoms
- Receding Hairline: Progressive loss of hair at the front of the scalp, sometimes extending to the sides and back.
- Loss of Eyebrows: A significant proportion of those with FFA also experience eyebrow loss.
- Scalp Changes: The affected skin may appear pale, shiny, and smooth due to the scarring.
- Redness and Small Bumps: In the early stages, there might be redness and small pimple-like bumps around hair follicles.
Causes and Risk Factors
While the precise cause is unknown, several theories and observations exist:
- Autoimmune Reaction: The body’s immune system may mistakenly attack hair follicles, leading to inflammation and scarring.
- Hormonal Changes: Given its prevalence among postmenopausal women, hormonal changes might play a role.
- Genetics: Some evidence suggests a familial predisposition.
Treatment of Frontal Fibrosing Alopecia
Currently, there’s no cure for FFA, so treatments aim to halt the progression of the disease:
- Corticosteroids: Topical, oral, or injected steroids can help reduce inflammation.
- Calcineurin Inhibitors: Topical treatments like tacrolimus or pimecrolimus can be used to reduce inflammation.
- Antimalarial Drugs: Hydroxychloroquine is sometimes used, given its anti-inflammatory properties.
Role of Minoxidil and Finasteride in Frontal Fibrosing Alopecia
Minoxidil: Traditionally used to treat androgenic alopecia, minoxidil works by prolonging the growth phase of hair follicles and promoting hair growth. Some studies and anecdotal evidence suggest that minoxidil might help stimulate hair growth in areas affected by FFA. When used in combination with other treatments, it may offer an adjunctive benefit. However, it’s unlikely to reverse the scarring process or fully restore the hairline.
Finasteride: An oral medication primarily used for male and female pattern hair loss, finasteride inhibits the conversion of testosterone to dihydrotestosterone (DHT). Given that FFA is thought to be hormonally influenced and is often seen alongside androgenic alopecia in postmenopausal women, finasteride might offer benefits. Several studies have suggested that finasteride can halt or slow the progression of FFA, especially when combined with other treatments.
Best value products
