Study Probes Frontal Fibrosing Alopecia Risk Factors

Cicatricial Alopecia is the umbrella term given to various forms of scarring hair loss whereby the hair follicles are chronically damaged, often leading to permanent baldness in the affected areas.
Example of Frontal Fibrosing Alopecia An Example of Frontal Fibrosing Alopecia


This encompasses various hair loss conditions as well as bald patches caused by burns or injury, for example.

One of them, Frontal Fibrosing Alopecia (FFA) is predominantly found in women - though can also affect men - and causes a deep receding hairline whereby a smooth, thick band of pale skin becomes increasingly visible around the scalp. There are currently no treatments for this condition, which experts say is on the rise.

Little is known about FFA, which is believed to be inflammation-induced. However, findings from a Spanish multi-centre casecontrol study into risk factors associated with Frontal Fibrosing Alopecia published in the journal of Clinical and Experimental Dermatology on 26th September 2018, hope to shed some light into environmental and hormonal issues linked to this particular form of scarring alopecia.

Hormonal, health and environmental factors found


The research was carried out by doctors from the dermatology departments at Hospital Universitario Ramon y Cajal, and Hospital del Sureste, in Madrid.

After recruiting 664 female participants, 335 with FFA and 329 as controls, and 106 men where 20 had FFA and 86 were controls, these volunteers all completed 'an exhaustive' questionnaire at various locations. The study methodology states that this covered 'pharmacological, environmental, hormonal, social, job exposure, lifestyle, drugs and diet factors to which they were exposed at least 5 years prior to the onset of the disease.'

sun cream sunscreen sun lotion FFA linksOn analysing the results and comparing age and sex-matched control subjects' responses to those with FFA, statistical associations between hormonal, health and environmental factors and Frontal Fibrosing Alopecia were found but these differed for men and for women.

For women, the key risk factors were shown to be:

-  a history of pregnancy

-  use of facial sunscreen

-  hormone replacement therapy

-  use of raloxifene (a prescription medication used to treat and prevent osteoporosis after menopause)

-  use of/exposure to alkylphenolic compounds (used in the production of ingredients found in detergents and cleaning products)

-  having rosacea (a skin condition which mainly affects the face)

-  having lichen planus pigmentosus (a rare form of lichen planus which causes highly pigmented lesions on the skin and is believed to be an autoimmune disorder)

-  having hypothyroidism (an underactive thyroid)

For men, use of facial sunscreen or anti-ageing creams provided the most statistically significant risks of FFA.

These findings, at least in part, back previous research which discovered links between thyroid problems, the use of facial sun cream and Frontal Fibrosing Alopecia.

Potential treatments for Frontal Fibrosing Alopecia


Though currently there are no approved treatment methods for Frontal Fibrosing Alopecia, a number are being developed with a number currently in various stages of clinical trial testing.

These include PRP for FFA - scalp injections of platelet rich solutions derived from the patient's own blood, corticosteroid treatments, and a drug presently used for the treatment of psoriasis known as Apremilast. We will update this Belgravia hair loss blog with any significant developments in this area as soon as information becomes available.

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The Belgravia Centre

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