Frontal fibrosing alopecia (FFA) is a condition that causes hair loss on the front and sides of your scalp. Hair loss may also occur on eyebrows, eyelashes and other body parts. An autoimmune reaction, genetics or hormones may cause FFA. Healthcare providers diagnose FFA with a physical exam and skin biopsy. Treatments include medications to slow hair loss.
Frontal fibrosing alopecia (FFA) is a condition that leads to hair loss (alopecia) at the front and sides of your scalp. FFA may also affect hair on other parts of your body, most commonly your eyebrows.
Frontal fibrosing alopecia usually worsens over time. Healthcare providers can use treatments to slow frontal fibrosing alopecia. But these treatments won’t restore any hair you’ve already lost.
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Frontal fibrosing alopecia usually affects women and people assigned female at birth (AFAB) after menopause, most often after age 50. But women as young as age 21 can have FFA, too. Women of African descent also tend to show symptoms earlier, sometimes in their early 40s. Men, or people assigned male at birth (AMAB), rarely have this condition.
People may be at higher risk of frontal fibrosing alopecia if they have:
Frontal fibrosing alopecia is a somewhat rare condition, but growing numbers of people around the world are getting it.
Researchers don’t know the exact cause of frontal fibrosing alopecia. But they suspect:
Researchers also suspect that environmental factors may trigger FFA in people with a family history of the condition (genetic predisposition). These environmental factors may include:
The main symptom of frontal fibrosing alopecia is hair loss along the front and sides of your hairline. This hair loss can start slowly but worsen over time. Your skin in this area may look normal, but can also appear:
The other main FFA symptom is eyebrow loss. This symptom may happen before the hair loss on your scalp. Eyebrow loss affects between 80% and 90% of women with FFA.
Other early symptoms of FFA may include:
Less common symptoms of frontal fibrosing alopecia include hair loss from:
More rarely, people with white hair may notice a few hairs return to their original color.
Your healthcare provider will ask about your:
Your healthcare provider will do a physical examination and take a close look at your:
If your healthcare provider suspects FFA, they may do a skin biopsy. During the biopsy, they’ll:
Your healthcare provider may also do other tests, including:
These tests can help your provider rule out other conditions such as:
There isn’t a cure for frontal fibrosing alopecia. But treatments can help to slow its progression. Your healthcare provider may suggest a combination of medications, including:
Other treatments may include:
Depending on the treatment, you may start to see a slowing of hair loss in six to 18 months.
You can’t reduce your risk of frontal fibrosing alopecia. But the earlier you begin treatment, the better the chances of slowing the hair loss.
How quickly FFA develops varies from person to person. Without treatment, your hair loss may worsen over time.
Your hairline may move back on your scalp. You may also develop bald patches or hair loss in a zigzag pattern. But sometimes, hair loss stops on its own without treatment.
If you have FFA, treatments usually help slow hair loss over time. But hair you’ve already lost usually doesn’t grow back.
Hair loss can be very upsetting. It may affect your mental health and sense of well-being. Talking to close friends or family members or a therapist can help.
You may also want to join a support group for people with FFA. Sharing experiences with others in a similar situation can be a great source of comfort and information.
You should also try to begin treatment for FFA as early as possible. The longer you wait, the more hair loss you may see.
You can also take care of yourself by:
See your healthcare provider if you have concerns about any side effects from your treatments. They may also be able to offer tips to help lessen the look of the hair loss, including options such as powders.
A note from Cleveland Clinic
Frontal fibrosing alopecia (FFA) is a condition that results in hair loss on the front and sides of your scalp. You may also have hair loss on eyebrows, eyelashes and other parts of your body. FFA mainly affects women after age 50, though men and younger people can also have this condition. Researchers don’t know the exact cause of FFA, but they believe an autoimmune reaction, genetics or hormones may play a role. Healthcare providers diagnose frontal fibrosing alopecia with a physical examination and a skin biopsy. They usually suggest a combination of medications to treat this condition. Although there isn’t a cure for FFA, early treatment can help slow its progress.
Last reviewed by a Cleveland Clinic medical professional on 06/13/2022.
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