What Women Should Know About Frontal Fibrosing Alopecia
Hair loss can be emotional, frustrating, and confusing, especially when it feels like no one talks about the kind you’re experiencing. One form of hair loss we’re seeing more of, particularly in women, is frontal fibrosing alopecia (FFA). It’s a condition that tends to sneak up, affecting the hairline and eyebrows first. And unlike more common types of hair loss, FFA can be much more stubborn.
Frontal fibrosing alopecia is a type of scarring alopecia, meaning it can permanently destroy hair follicles if it’s not addressed early. Most often, we see it in postmenopausal women, but it can affect younger women too. The hallmark sign is a slowly receding hairline, often accompanied by thinning or complete loss of the eyebrows. Some women notice a shiny or pale appearance to the skin where hair used to grow, and in some cases, there’s redness, itching, or discomfort.
We still don’t have all the answers, but researchers believe FFA is autoimmune-related. That means the body’s immune system mistakenly attacks its own hair follicles. There may be hormonal influences at play too, which is why it’s more common in women after menopause. Environmental factors, including certain skincare products like sunscreens, have also been explored, though nothing has been definitively proven.
The first step is getting the right diagnosis. If you suspect your hairline is receding in an unusual pattern, especially if you’re also losing your eyebrows, see a board certified dermatologist. They can perform a scalp biopsy to confirm FFA and may start treatment with topical or injected steroids to calm inflammation. That’s often the first line of defense, and it’s essential to start there before jumping to more systemic treatments.
If steroid treatments don’t offer enough control, oral medications like minoxidil or finasteride may be considered. Oral minoxidil (yes, the same active ingredient in Rogaine, just in pill form) is used off label in female patients to help preserve hair follicles under attack. It can slow the progression of loss and, in some cases, improve thickness, but it’s more about preservation than regrowth.
At Leonard Hair Transplant Associates, we’re known for helping patients restore their hair, but frontal fibrosing alopecia is an exception. Because FFA involves active inflammation and scarring, transplanted hairs are unlikely to survive. The immune system tends to treat the new follicles just like the old ones, attacking and ultimately destroying them. So, while a hair transplant might seem like an obvious fix, it’s unfortunately not a reliable option in cases of FFA.
If you’re dealing with frontal fibrosing alopecia, you’re not alone, and you’re not imagining it. This condition can be distressing, but early intervention matters. The sooner it’s diagnosed, the better the chances of preserving the hair you still have.
If you’d like guidance navigating your next steps, our team at Leonard Hair Transplant Associates is here to help with honest advice, even if a procedure isn’t the right path forward. Start with a dermatologist, and if medical therapy becomes part of the plan, we’re happy to work alongside your provider to help you make informed decisions.