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Frontal Fibrosing Alopecia: Women’s Receding Hairline

Although it sounds contradictory, a widow’s peak is generally a term reserved for men. However, as more people become aware that hair loss is not just a male domain, it’s becoming clear that some women also experience a receding hairline. The female version, however, is called frontal fibrosing alopecia.

What is it?

Frontal fibrosing alopecia - a woman's receding hairlineFrontal fibrosing alopecia is a form of scarring alopecia, characterised by a band-like pattern of hair loss on the front and sides of the scalp. It’s a progressive condition that appears as a receding hairline – similar to that in men – and can cause women to lose up to five inches of hair. The eyebrows are often thinned or may even be absent and there have been cases of associated eyelash and abdomen hair loss, but these are rare.

Unlike most forms of hair loss, which can be mainly attributed to heredity, scientists believe frontal fibrosing alopecia is caused by the immune system attacking the hair follicles and causing inflammation. This damages the stem cells within the follicle and if they are damaged, hair is unable to grow back. The skin in the affected area may look normal but is usually pale or mildly scarred. There may also be mild redness and inflammation around the hair follicles.

Frontal fibrosing alopecia can be confused with other forms of hair loss like female pattern hair loss or traction alopecia , and although it is a form of scarring alopecia, it is not like other forms of scarring alopecia such as discoid lupus erythematosus and folliculitis. That is why an expert diagnosis from a hair loss professional is always recommended for any type of alopecia.

Who is at risk?

Also known as post-menopausal frontal fibrosing alopecia, it mostly affects post-menopausal women over the age of 40, although it has been reported in men as well and may occur before menopause.

Because the vast majority of women who suffer frontal fibrosing alopecia are post-menopausal, it is thought that there may be a hormonal link. Genetic factors are also possible and because it’s a fairly new condition, an environmental trigger is thought to possibly be at work also.

What can be done?

Frontal fibrosing alopecia - a woman's receding hairlineDiagnosis is usually verified by the presence of the typical whitish, scarred strip of hair loss at the hairline and possibly reddened, inflamed hair follicles. However, other evaluation methods may include a complete blood count, a thyroid function panel and other hormone tests.

Oral steroids and antimalarials may temporarily slow the progression of hair loss, but they could have side effects such as depression, insomnia, abdominal pain, skin rashes and retina damage. And despite the assumed hormonal link, hormone replacement therapy has not been shown to be of any benefit.

Treatment is based around trying to control the inflammation causing the damage to the hair follicle. Some surgeons will also carry out hair transplants on the scarred areas of hair loss in frontal fibrising alopecia.

Up to 50% of women experience hair loss after menopause and most of the time it’s presented as diffuse-spread hair all over the scalp, or thinning hair at the crown. Clinical hair loss treatments have demonstrated to be many a girl’s saving grace when it comes to maintaining hair growth, be it pre- or post-menopause.

If you’d like to find out more or would like to arrange a free consultation with a hair loss specialist, call the Belgravia Centre on 020 7730 6666 or send an email. Or, if you can’t make it to the centre you can still take advantage of the online diagnostic form. Be sure to attach a few photos (see before and during treatment photos for guidance) and once you’ve submitted the form, a treatment advisor will contact you to discuss your results and personal recommendations.

More Information:
Hair Loss in Women
Hair Loss Success Stories
Hair Loss Product Reviews

Interesting Articles:
When Hair Loss Can Be Dangerous
Why Female Hair Loss Should Be Treated
Hair Restoration Methods

25 Comments

13th July, 2016 at 4:15 am

Alyssa cantor

What are the treatment options

13th July, 2016 at 9:42 am

Sarah Belgravia

Hi Alyssa, At present there are no treatment options for FFA unfortunately, as it is a form of scarring alopecia.

20th July, 2016 at 10:41 am

Anamika

Hello, I am 30 years old and in the past 1 an half year have been facing frontal hair loss. I had consulted a doc and i was recommended Tugain 5% minoxidil along with iron tabelets, however after 1 and half month of application i started getting itchiness on the areas where i use to apply tugain so i stopped the application. I consulted the doc about it and he recommended another treatment PRP for it. I juss bit scared of it now. could you suggest me some other natural treatment for it ? Thanks

8th August, 2016 at 11:51 am

Sarah Belgravia

Hi Anamika, we hope this answer is helpful to you.

11th December, 2016 at 9:45 am

Laura

I am 35 and have always had a high hairline however over the last year I have noticed hair loss more on one side resulting in a 1-2inch bald area at the front. Is this FFA and if not what could it be?? I am very self conscious about it and dread windy days or swimming when my hairline is exposed.

13th December, 2016 at 12:17 pm

Sarah Belgravia

Hi Laura, please find a full response to your query here. We hope this is useful.

7th August, 2017 at 5:56 pm

Alexia

Hello, I am 34 years old and I have a hair loss only on the left side: Front and temples. Test hormones are ok, I think it is very sparse. I find spaces of 2mm between some hair but also very light...

8th August, 2017 at 11:08 am

Sarah Belgravia

Hi Alexia, unfortunately we can't diagnose this based solely on this information, we would need to examine your scalp and take some medical details too. It may be female pattern hair loss which can often be most noticeable in the areas you describe. We would need to assess you to make a proper diagnosis, however. You can either arrange an appointment for a free consultation at one of our Central London hair loss clinics or if you are based outside London/the UK, please fill out our online consultation.

8th August, 2017 at 1:18 pm

Alexia

Thank you for your quick response! Sorry to answer you a second time: the message was not whole! I think of an FFA since it touches the front of my scalp. I have no itching, I have no pain, I have no redness, but when I look close to some hair I find scale around the hair. I do not know if it's due to traction or FFA; thanks again

8th August, 2017 at 3:50 pm

Sarah Belgravia

Hi Alexia, no problem! This sounds like a hair loss condition combined with a scalp issue. Scales or a flaky scalp are common in a number of scalp issues but uncommon in hair loss conditions. We recommend having a personal consultation as a hair loss specialist will then be able to give you a professional, personal diagnosis of your hair and scalp problems, as well as custom treatment options for both. We hope this helps.

2nd September, 2017 at 10:28 pm

Irene Ward

Hi, I seem to be receding as described, it's like a band from ear to ear. I have noticed that the Base of each hair is red and flaky. I no longer put my hair back off my face and now have a fringe to cover my forehead. Could this be FFA? Thank yoy Irene

4th September, 2017 at 10:14 am

Sarah Belgravia

Hi Irene, it is possible that this is FFA or it could be Ophiasic Alopecia - we would recommend having a consultation either in person or online, in order to get a confirmed diagnosis.

10th October, 2017 at 2:36 am

Lo

Would a scalp biopsy in the thinning area where FFA is suspected, give a certain pattern in the findings? Thanks

12th October, 2017 at 12:57 pm

Sarah Belgravia

Hi Lo. Please find a full response from one of Belgravia's hair loss specialists, here.

24th January, 2018 at 9:33 am

Sanjana

Sir,I'm 21 years old young girl,from nearby 4-5 months I'm feeling that my hairline is receding from middle part and some of the left area,so I can't make ponytails and another without partition hairstyles,it clearly appear when I make sleek ponytail etc. But when I make partition hairstyles its not appear,sometimes I feel pain on that receding part but only when I wese tight bun etc,so I leave these styles ,I think it is because of my those hairstyles so finally what should I do? Is it treatable? By itself? Or not I used some natural home remedies like ginger,onion etc. But it didn't give result so I drop this,so what should I do? Or any caring about it?

24th January, 2018 at 11:52 am

Sarah Belgravia

Hi Sanjana, we can't diagnose you just from what you say here but it sounds like a potential case of Traction Alopecia. You can find out more about this on our dedicated Traction Alopecia page.

29th April, 2018 at 5:19 pm

Kristine

Hi, I'm a 46 year old woman, premenopausal, and have experienced generalized hair thinning over the past couple of years, but it's particularly noticeable at the front hairline and temples. I can see from photos that my hairline has receded about a cm or so and it looks very thin there. I've been on iron supplementation for over a year as my ferritin was down to 4 - it has picked up but was still in the 20s when last checked - and have been using minoxidil (regaine 5%) for nearly a year, as my GP thought it could be either androgenic alopecia / iron deficiency / a mix of both. My hair has thickened quite a bit since then and looks better overall, except at the hairline which has continued to recede. I have miniaturized hair in this area too, with lots of little hairs that don't seem to grow any longer or thicker. It does look like a balding man's hair at the front. Do you think this is more likely to be androgenic alopecia than frontal fibrosing alopecia? I've read about FFA online but my GP never mentioned it. Do you get miniaturized hairs in this condition, or do the hairs at the front just drop out? I was convinced it was hormonal hair loss, just more in a male pattern, but have been confused since I read about FFA. Many thanks for any info you can give.

30th April, 2018 at 9:42 am

Kristine

Just to add to the above - I've not noticed any redness around the hairline and the hair has not receded in a particularly bandlike pattern. It started at the right side and then the left side seemed to thin and catch up. Traction alopecia isn't a possibility as I've hardly ever worn my hair fastened back and have never used extensions or anything else that pulls on the hair.

2nd May, 2018 at 11:05 am

Sarah Belgravia

Hi Kristine, we hope this full response from one of our senior specialists is helpful.

12th May, 2018 at 6:35 am

YANNA

Hello, I am a woman of 34 years old. for several months, I noticed a hair loss in the frontal and temporal area. I went to several dermatologists because I am afraid to have fibrotic frontal alopecia. I notice that I have a lot of transparent hair of 1 or 2 mm between the black hair. but I wanted to know if in fibrosing alopecia, there are these little white hairs, down with some terminal hair? thank you

16th May, 2018 at 11:11 am

Sarah Belgravia

Hi Yanna, here's a full response to your query from one of our senior hair loss specialists. We hope this information is helpful.

29th May, 2018 at 8:59 am

Jane

Hi, I've been seeing a dermatologist for about 18 months and have been diagnosed with Frontal Fibrosing Alopecia. I work as a nurse, so I'm dealing with the public every day and my hair loss is becoming harder to hide. I'm stuck with one hairstyle and I have to keep it short, so I don't have to put my hair up. What treatments are available for me?

29th May, 2018 at 9:29 am

Sarah Belgravia

Hi Jane, unfortunately there are no treatments for Frontal Fibrosing Alopecia as yet. Sorry not to have better news for you.

6th June, 2018 at 11:36 am

Bree

Hello, are lonely hairs, pale skin at the hairline an a moth-eaten looking hairline always a sign of ffa? I‘m only 30 years old and afraid this could be this condition. Thank you

6th June, 2018 at 11:45 am

Sarah Belgravia

Hi Bree, it's hard to know from your description what condition you are experiencing. We would advise you to visit one of our City of London or Central London hair loss clinics for a consultation, or complete our online consultation form if your location makes this a more convenient option, so that one of our hair specialists can provide you with a proper diagnosis and appropriate treatment recommendations.

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