Inflammation in Frontal Fibrosing Alopecia (FFA)

Inflammation May or May not be Visible in FFA

Frontal fibrosing alopecia (“FFA”) is a type of scarring alopecia. It affects the frontal hairline as the name suggests but also many areas of the scalp, eyebrows, eyelashes, and body hair. Frontal fibrosing alopecia of the scalp may or may not look inflammatory. In some cases, the scalp is red around the affected hairs but not always. Biopsies show scarring, loss of vellus hairs ... and inflammation.

Typical scale and redness around hair follicles in a patient with inflammatory FFA

This photo shows the scalp of a patient with clinically very inflammatory frontal fibrosing alopecia. The scalp is obviously red and there obvious scale around hairs. As with many patients, the very front of the scalp is more likely to show the red scaly changes compared to the sides of the scalp (near the ears). The precise reasons for these differences are not entirely clear.