Your description of Frontal Fibrosing Alopecia (FFA) seems to fit my scalp condition. Can you help?

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Hello Shuna,

Your description of Frontal Fibrosing Alopecia seems to fit my scalp condition. I’ve had this for about two years, possibly three. My eyebrows are almost non-existent, so on Saturday, had a session of micro-pigmentation which has given me amazing semi-permanent eyebrows. Beforehand, the person who did it pointed out the redness and puffiness across my brows and when looking at my hairline, suggested that I might have frontal fibrosing alopecia. The thought of losing 6cms of hair depth worries me as I’ve lost about 2 cms already.

My doctor was not worried when I raised my concerns.

Mrs X


Dear Mrs X,

Here are some photos of the condition you mention, it is interesting to see how in fact the condition can be disguised quite well, note the involvement of the eyebrow hair (very well tattooed on here). This is often the first symptom the sufferer notices some while before the hair changes. In women, I have observed, the scalp hair most often is lost from the sideburn area in front of the ears. There is often marked inflammation around the hairs and can have some scale present too, it varies in sensation from itchy, to hot, others even say it feels prickly. Thanks go to this kind lady who agreed to help others by having her photo taken, in a way perhaps even her family do not see her- for the good of helping others recognise the signs as early as possible.

If this is indeed your condition then there are ways to at least control its progression.

An hour consultation would be the best way to decipher, there may be a scalp application I could demonstrate the use of in-clinic treatment (for home use). The fact that you live a little way from me is not a problem, after your initial visit to me, we can follow up on occasion via Skype or FaceTime if you feel it will support you better? I also feel it prudent for your hairdresser and me to act as “a team” around you and work together to achieve the very best for your hair.

You may be interested to know that this condition is a scarring one so unfortunately, the lady pictured here will not be able to regrow the frontal hairline again. Sometimes this condition may need medical intervention for this auto-immune condition or possible investigations into antibody presence but the majority of my patients with this form of Lichen Planus, are able to treat this condition successfully at home. I use a non-steroidal combination of creams and lotions and offer support and guidance as required by each patient. As you will appreciate, there may be a supplement and lifestyle guidance I will share with you also.

I do hope this has explained a little more, clearly, my consultation with you would allow me to explain in more detail, draw diagrams and achieve a better ability to reassure you.


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