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  • Writer's pictureKate Holden

Frontal fibrosing alopecia: Causes of receding hairlines in women

Updated: May 30, 2020

90% of men by the age of 40 see some recession to their front hairline, but in women a receding hairline is much less common. Whereas a male receding hairline is a sign of male pattern hair loss, the same condition in women typically causes general thinning rather than a receding hairline.

In this blog, we explain how a condition called frontal fibrosing alopecia can cause a receding hairline in women.

If you are worried about your hairline receding, book a consultation at Kate Holden Clinic for expert examination, diagnosis, and treatment plans.

What causes a female receding hairline?

There are two main causes of female receding hairlines. The first is traction alopecia, where tight hairstyles such as ponytails and braids damage the follicles over a long period of time. The second cause, which is looked at in more detail here, is a condition called frontal fibrosing alopecia.

What is frontal fibrosing alopecia?

Frontal fibrosing alopecia is a type of scarring hair loss. It is related to a condition called lichen planopilaris, which is the term for when lichen planus, a common skin disease, affects hair follicles. The immune system attacks the follicles, causing scarring and hair loss.

The triggers of frontal fibrosing alopecia are not entirely understood, but it is thought that an overactive immune system, genetics and hormones play a role. It has also been theorised that there may be environmental factors, such as a chemical called titanium dioxide which is commonly found in sun cream and skincare products, however this has not been proven conclusively.

This condition is most commonly seen in postmenopausal Caucasian women, but anyone may be affected.

How is a receding hairline diagnosed?

Frontal fibrosing alopecia is diagnosed after close examination of the scalp. The hairline progressively moves backwards, leaving a band of pale, shiny, smooth skin at the front hairline. The scalp can be inflamed, red, and flaky, and you may be able to see individual hairs. Your eyebrows and the hairline by your ears may also be affected.

You may need a skin biopsy to confirm whether your receding hairline is caused by frontal fibrosing alopecia. For examination and diagnosis, you will need to see your GP or a trichologist in the first instance who can then refer you to a dermatologist.

How can you stop a receding hairline?

If your receding hairline is caused by frontal fibrosing alopecia, treatments are focused on preventing any further hair loss. As frontal fibrosing alopecia is a scarring condition, the hair will not grow back once it has been affected.

Treatments for frontal fibrosing include:

  • Corticosteriods – these can either be applied topically to the affected area on the scalp or can be administered by an intralesional injection and work to slow or stop the progression of the receding hairline and to reduce the inflammation.

  • Antibiotics – these are prescribed to calm inflammation and redness and can include antibiotics such as doxycycline and tetracycline.

  • Antiandrogen medications – a medication such as finasteride, which lowers the production of a catalysed form of testosterone called dihydrotestosterone, may be given if androgens are thought to be affecting your hair loss.

  • Immunosuppressants – these include tacrolimus ointment and a medication called mycophenolate mofetil which suppress the immune system to lessen inflammation.

  • Camouflage treatments – wigs, hair pieces and hair systems can be worn to improve the appearance of a receding hairline.

If you’ve noticed that your hairline is receding, book a consultation with the Kate Holden Clinic for professional examination, diagnosis, and treatment.

Visit the Kate Holden Clinic hair treatment centre in Manchester to see a registered trichologist.


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