Frontal Fibrosing Alopecia Dermatologist2019-11-08T17:42:02+00:00

Feel in charge of your skin

PERSONALISED DERMATOLOGY TREATMENT PLANS

Frontal fibrosing alopecia is a type of scarring alopecia which affects the hairline in the front of the scalp

IN THESE VIDEOS, I EXPLAIN THE SYMPTOMS AND CAUSES OF HAIR LOSS – AND HOW TO TREAT IT

In the videos above, I explain things in a simple way that applies to most people who have frontal fibrosing alopecia. Of course, no video or website can replace the value of a personalised consultation. At your consultation, you can have your skin carefully examined and get an expert recommendation to help you resolve your condition.

Treatment helps people of all ages take control of their skin condition and get their life back.

How does frontal fibrosing alopecia impact people on a day-by-day basis?

EVEN THOUGH THERE MAY BE NO PHYSICAL SIGNS, HAIR LOSS CAN BE EXTREMELY DISTRESSING

Hair loss affecting your hairline

Your hair loss will be at the front of your scalp, the sides and around your ears, in a band-like distribution. Sometimes, it can affect your eyebrows and hair at other body sites.

People experience frontal fibrosing alopecia in different ways

You may experience itching, redness and scaling of the scalp. You may notice no scalp irritation at all. Though there may be no physical signs, hair loss can be extremely distressing.

Your hair loss might always be in the back of your mind

Extreme self-consciousness is common. Is it obvious? Are people staring? Will people still like you if you lose your hair? A person’s hair can be a part of their identify, and that loss of identify can affect every waking moment.

Will your hair grow back?

Unfortunately, as frontal fibrosing alopecia is a scarring hair loss, any hair that you lose cannot grow back. However, treatment can prevent further hair loss.

Is there any hope at all?

If caught early enough, we can stop frontal fibrosing alopecia in its tracks with suitable treatments. This means that, while there is no cure for frontal fibrosing alopecia, further damage to the hair can be prevented.

What my patients love about my service

MY PATIENTS ARE MY BEST PROMOTERS

Please pass on my thanks to Dr Pratsou for her assessment on my continued taking of roaccutane.

She was completely right, I didn’t need a new course, I needed to move away from the drug. The creams she gave me and Cetaphil recommendation have meant my skin has been the best it’s ever been (ongoing and since I saw her) ALL SUMMER :))))) I’ve had zero problems…and I’m loving it.

Thank you once again.


Phillip, Acne

“Dear Dr Pratsou,

Following the consultation today I feel it appropriate to say thank you for your help in dealing with my rosacea.

On each occasion, I have visited your department I have noticed the kindness and cheeriness of all the staff I have encountered and particularly wanted to say that you made me feel at ease with your calmness and excellent manner.

All is much appreciated.”


Anne, Rosacea

“Thank you very much!!

You three were (and are) a great team!

I will remember you.

You made me feel comfortable.”


Ellie

“Tania,

Please pass to Dr Pratsou my thanks for her skilled work.

The wound is healing beautifully and now the stitches are out it looks as though it will be almost invisible once fully healed.”


Graham, Skin cancer removal

“Dear Dr Penelope, Rena & the team, (I can’t remember the nurse’s name who helped me during my 2 procedures at the Spire!)

I wanted to thank you for your support and help during a very difficult time. You guys do a wonderful job – and we are eternally grateful for your help.”


Clarissa, Skin cancer

“I would like to put on record how impressed I was with the operation you performed for the removal of the SCC on my neck. I cannot even see where the cut or the stitches were! I am indeed very grateful for the excellent work you do.”


Harry, Squamous Cell Carcinoma

“Dear Dr Pratsou,

I am very grateful to you for your diagnosis, recommended treatment and advice. Your letter to my GP sets out both the course of events, and your own analysis of probable condition and possible cause, clearly summarising our discussion.

I hope there will be no recurrence but I will certainly come back to you if there is.”


Ryan, Skin rash

“Dear Tania,

Please pass on my thanks to Dr Pratsou. I saw her this morning for a mole check. She was so lovely and reassuring. Please also thank the two nurses who assisted her during the mole removal procedure. I was very nervous, but they were very efficient, which meant I did not have too long to think about it, but most of all they were very kind. They kept me distracted and calm, which made a huge difference. Thank you also for your efficiency in both booking me in so quickly.”


James, Mole removal
Dear Ms. Pratsou,

I am writing to thank you for the care you have given me in the past few months. From the moment I walked into your consulting room with a lesion on my cheek, a lesion that I fully expected to be some sort of skin cancer (and it was), you have been thorough, reassuring, respectful and in every way professional.

You recognised that I had some insight into the condition of my skin and the procedures required to treat me. You listened to me. You projected expertise and compassion.

During the procedure to remove the growth you ensured that the atmosphere in the treatment room remained not only calm, but actually pleasant. Had it not been that you were excising a growth and sewing me up, I almost felt as if you, me and the nurse were at some sort of women’s discussion group. The time flew by. I had zero anxieties about the procedure and as we both know now, the wound healed flawlessly.

Thank you for your expertise and your communication skills and all round good nature. I feel very lucky.


Karen Tatom, Skin cancer removal

We have replaced the images and names of real patients who provided these testimonials to protect their privacy.

The first step to feeling in charge of your skin is to book an initial consultation

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STEP 1 – CALL US
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Give us a call on 01183735198 and we’ll help guide you towards a first appointment.

MEET WITH ME

I’ll see you and examine your skin before I recommend treatment. In some cases, I can begin treating your condition on the same day.

FEEL IN CHARGE OF YOUR SKIN

I’ll guide you down the road towards a resolution of your skin condition so that you can get back to normal life.

More information about frontal fibrosing alopecia

FOR THOSE WHO WANT THE DETAILS

Frontal fibrosing alopecia is a type of scarring alopecia which affects the hairline in the front of the scalp. Sometimes, it can also affect the scalp around the ears and the eyebrows.

Frontal fibrosing alopecia is thought to be a variant of lichen planopilaris, which involves inflammation and destruction of the hair follicles.

It tends to affect Caucasian postmenopausal women, though it can also affect younger women, men, and people of other ethnicities.

Symptoms include:

  • hair loss affecting your hairline at the front of the scalp, the sides and around the ears, in a band-like distribution
  • sometimes, it affects your eyebrows and hair at other body sites.
  • you may experience itching, redness and scaling of the scalp
  • you may notice no scalp irritation at all.

Though there may be no physical signs, hair loss can be extremely distressing.

Frontal fibrosing alopecia is thought to be an autoimmune condition.

Lymphocytes (cells that are part of the body’s immune defence system) attack the hair follicles, resulting in hair loss.

Genetic and possibly hormonal factors might play a part.

I take a careful history and examination of your scalp to look for evidence of hair loss and scarring.

Sometimes, I will advise taking photographs and some measurements at baseline to help monitor your future progress.

You may require a scalp biopsy so that we can confirm the diagnosis.

Treatments include:

  • an ultrapotent topical steroid application to affected areas. This can often be combined with oral treatments
  • alternatively, topical Tacrolimus (Protopic) ointment can be used to suppress local inflammation
  • I often use certain antibiotics called tetracyclines (for example, Doxycycline) for prolonged courses due to their anti-inflammatory effects
  • Hydroxychloroquine, which is an antimalarial drug, can be very effective in switching off activity in frontal fibrosing alopecia. You may require a 6-month initial course to see whether this is effective
  • I sometimes use immunosuppressive tablets (for example, mycophenolate mofetil) when other treatments have been unsuccessful.

Wigs, hairpieces, extensions, and hair fibres can be particularly helpful in managing this condition.

“Can my frontal fibrosing alopecia be cured?”

Unfortunately, there is no cure for frontal fibrosing alopecia.

Dermatologists aim treatments at stopping further hair loss and scarring.

In most cases, the condition eventually burns itself out after some years.

“Can I grow back the hair that I’ve lost?”

Unfortunately, as frontal fibrosing alopecia is a scarring hair loss, any hair that you lose cannot grow back. However, treatment can prevent further hair loss.

“Where can I get more information and support?”

Patient support group:

Alopecia UK
Tel: 0800 101 7025
E-mail: info@alopecia.org.uk

You can find further useful information on:

“What else can I do?”

Some hairdressers specialise in hair systems for hair loss/alopecia.

You can use extensions in long hair through certain specialist hair salons.

If you have extensive hair loss, you may find a weave or wig helpful. There are some extremely realistic choices nowadays. You can also obtain a wig via an NHS prescription.

Affiliations and memberships

I AM PROUD TO BE ASSOCIATED WITH THE FOLLOWING ORGANISATIONS

Questions and answers

RELEVANT AND INFORMATIVE VIDEOS AND ARTICLES

About the author

Dr Penelope Pratsou | Consultant Dermatologist

MBChB, MRCP (UK) (Dermatology)

I’m Dr Penelope Pratsou, a skilled independent Consultant Dermatologist based in Berkshire. I have specialist expertise in the diagnosis and management of all skin cancers, and in performing mole checks. I’m a trained skin surgeon and remove skin cancers, moles, skin tags, cysts and warts.

I also have invaluable experience in dealing with all skin conditions, from the common skin complaints of acne, rosacea, eczema and psoriasis, to the rarer and more complex skin problems, having seen it all through years of NHS work.

After I obtained my Membership to the Royal College of Physicians, I undertook rigorous specialist training in dermatology, before being appointed as a Consultant Dermatologist at the Royal Berkshire Hospital, Reading. There, I helped set up and lead a busy clinic for the diagnosis and treatment of suspected skin cancer. I was also actively involved in supervising and training both dermatology and GP trainees.

Alongside my increasingly busy private practice, I have maintained an NHS practice in Oxford in order to continue to engage with challenging cases and to develop my specialist interest in skin allergy.

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