What is frontal fibrosing alopecia?

Frontal fibrosing alopecia, or frontotemporal hairline recession, is a clinical condition experienced most frequently by, but not limited to, postmenopausal women. It causes complete progressive hair loss from the front and sides of the head in a band-like fashion. Its cause is unknown and there are no known treatments, although there are some medications available that can slow or interrupt its course. The condition is commonly confused with other forms of alopecia and can be found in combination with them. Expert advice should be sought for diagnosis.

Hair loss, or alopecia, of any kind in women can be very disturbing and requires early diagnosis and management. Many causes of female hair loss can be successfully treated. Frontal fibrosing alopecia can be especially debilitating, as it causes complete hair loss in the area, not just thinning, and exposed skin may appear pale or scarred. It usually affects the front of the hairline and the sides of the head, but in some cases, eyebrows, eyelashes, and body hair may also be lost.

While it is still unknown what causes frontal fibrosing alopecia, doctors suspect that it may be related in some way to the immune system, which seems to attack the hair follicles causing inflammation and then permanent damage. The scalp around the follicles may be red and inflamed during this process. Once the hair is gone, it is usually pale or scarred.

The condition can be slow or fast and there is no treatment available to cure it. Various medications including oral and topical steroids, topical calcineurin inhibitors such as tacrolimus and pimecrolimus, immunosuppressive medications such as cyclosporine and mycophenolate mofetil, and oral antimalarials such as hydroxychloroquine have been used to slow the progression of frontal fibrosing alopecia.

These medications are not without potential side effects, especially when used long-term, which is often necessary with frontal fibrosing alopecia, so the prescribing physician will treat them carefully, patient by patient, according to symptoms. , severity and progression. of the disease The prescribed treatment may interact with other medications, so these should be disclosed to the prescribing physician. This includes over-the-counter, homeopathic, and complementary medicines.

Destroyed hair follicles do not regenerate, so once the damage is done, they will not grow back. A wig or hairpiece, or the use of headbands and clever hairstyles may be recommended. Psychological support, including support groups, is often recommended as the condition can cause body image issues.

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