Do I Have Frontal Fibrosing Alopecia? : Vellus hairs in hairline may mean "no"

Vellus hairs in hairline may mean "no"

Frontal fibrosing alopecia (FFA) is a scarring alopecia that affects women to a greater extent than men. Affected patients typical lose hair along the frontal hairline but many different areas can be involved including the back of the scalp, the eyebrows, eyelashes and body hair.

FFA is becoming more common. The incidence is increasing worldwide for reasons that are not entirely clear. Both physicians and the geineral public are coming to better recognize the condition. Nevertheless, challenges still exist with it’s early recognition as well as in differentiating it from some types of androgenetic alopecia and alopecia areata.

One of the important features of FFA when viewed using a dermatoscope is that the FFA disease process generally destroys the tiny vellus hairs that are seen readily in the frontal hairlines of women. Such tiny vellus hair becomes even more prominent in patients with androgenetic alopecia.

If ones sees an abundance of vellus hairs under dermoscopy, it is less likely that FFA is a diagnosis to consider. This photo shows the frontal hairline of a patient with androgenetic alopecia. Vellus hairs are preserved.