Alopecia and a receding hairline

Gradual recession at the temples can occur with androgenetic hair loss. Persistent pulling from tight hairstyles can present with loss along tension-bearing edges. Frontal fibrosing alopecia can present with a progressively moving front hairline and may include eyebrow loss or scalp symptoms; it needs dermatology assessment because scarring can limit regrowth.

Notice whether the change is even on both sides, concentrated at the temples, or forms a band across the front. Short broken hairs near braids or extensions suggest tension, while redness, scale, burning, tenderness or smooth shiny skin around the edge raises concern for inflammation or scarring.

Family history and gradual progression can support a pattern-hair-loss assessment, but they do not rule out another cause. A dermatologist may inspect the follicle openings with magnification and compare density behind the hairline. Eyebrow and body-hair changes provide additional clues.

Release tension from tight braids, ponytails, extensions, clips or headwear that repeatedly pulls the same edge. Choose looser styles, reduce friction, and avoid aggressive brushing or chemical processing over irritated skin. Photograph the front and temples from fixed angles to document the direction of change.

Medical options depend on the diagnosis, health history and pregnancy considerations. Finasteride is used for selected people with pattern hair loss but is not suitable for everyone and requires clinician guidance. Hair transplantation may be discussed when loss is stable and donor hair is suitable; it does not switch off an active inflammatory or traction process.

Arrange a dermatology visit promptly if recession is progressing with eyebrow loss, itching, burning, pain, redness, scale or shiny skin where follicle openings seem absent. These features can accompany inflammatory scarring alopecia, where delay may allow further irreversible follicle damage. Sudden rapid loss or a new inflamed scalp area also deserves timely examination.

Ask whether the examination shows miniaturised hairs, breakage, inflammation or loss of follicle openings. Discuss which diagnosis fits the distribution, whether further testing is needed, what each treatment can realistically protect or regrow, and how pregnancy plans or other medicines affect the available choices.