Frontal fibrosing alopecia (FFA) is a patterned primary cicatricial alopecia that was first described in 1994. Once rare, the incidence of FFA has increased dramatically, representing the current most common cause of cicatricial alopecia worldwide. FFA typically begins in postmenopausal women with symmetrical, progressive recession of the frontotemporal hairline together with bilateral loss of the eyebrows. FFA has a distinctive clinical phenotype, which remains a challenge. The histology is identical to lichen planopilaris (LPP), but only a small number of patients have coincidental LPP, usually of the scalp. The vast majority of patients have no evidence of lichen planus elsewhere, and the symmetry and patterned nature of the hair loss are unusual for LPP. Frontal fibrosing alopecia (FFA) is characterized by scarring alopecia of the frontal hairline. Average age of onset is 56 years. FFA generally affects postmenopausal Caucasian women. There is no approved treatment for FFA. Topical or intralesional corticosteroids are first-line treatment. Second-line treatment includes systemic corticosteroids, hydroxychloroquine, 5-alpha-reductase inhibitors, topical minoxidil, and anti-inflammatory systemic medications.

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Hair Therapy and Transplantation

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