What should you know about frontal fibrosing alopecia lichen planopilaris?

This condition is a form of lichen planopilaris, where inflammation targets the follicle and can replace it with scar tissue. A receding hairline may be accompanied by eyebrow thinning, redness, scale, itching, or tenderness at the edge. The band of change can be subtle at first. Hair that has been replaced by scar tissue generally cannot regrow from that follicle, which is why activity and the remaining hair are assessed carefully.

See a dermatologist experienced in inflammatory hair disorders. Examination may include magnified scalp viewing and, when the diagnosis is uncertain, a small biopsy from an active margin. Treatment aims to calm inflammation and prevent further loss; options can include steroid injection into the skin and finasteride treatment when clinically appropriate. Do not start prescription treatment without discussing pregnancy potential, medicines, and personal risks.

Arrange timely care when the hairline is continuing to move backward, eyebrows are thinning, or the scalp edge becomes itchy, sore, red, or scaly. Rapid change, pustules, or crusting warrants prompt review because infection or another inflammatory disorder may need different management. New facial skin changes should also be reported.

Does my hairline show active inflammation or established scarring? Would a biopsy clarify the diagnosis? How will treatment be monitored, and is finasteride suitable for my circumstances?