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Classification of Frontal Fibrosing Alopecia

Frontal fibrosing alopecia is a chronic scarring alopecia with an unpredictable evolution. There are currently no classifications of this disease which may predict its prognosis. A recent study sought to analyse the differences in clinical presentation and evolution of frontal fibrosing alopecia patients to create a clinical and prognostic classification.

A cohort of 242 female patients with frontal fibrosing alopecia were included in a 12-month study. Their average age was 61.4 years.

Clinical characteristics of frontal hairline recession were used as the sorting variable between patterns of presentation. Patients were thus classified into three clinical patterns: 118 (48.8 percent) as linear, 109 (45 percent) as diffuse, and 15 patients (6.2 percent) as double line.

In a cohort of 109 patients homogenously treated with oral dutasteride and topical corticosteroid, stabilisation was achieved in 37.3 percent.

Double line pattern patients had less hairline recession and eyebrow involvement at the diagnosis and after treatment, when compared to their counterparts.

The study concluded that frontal fibrosing alopecia patients can be classified into three different clinical patterns with different prognoses. Double line pattern patients have the best prognosis, while diffuse pattern patients have the worst prognosis.

Read more about latest research in alopecia.


Moreno-Arrones, O. M., et al. (October 2017.) Frontal fibrosing alopecia: clinical and prognostic classification. Journal of the European Academy of Dermatology and Venereology. Volume 31. Issue 10. Pages 1739–1745. DOI: 10.1111/jdv.14287.

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