What is the first treatment tried for frontal fibrosing alopecia?

Frontal fibrosing alopecia is a scarring form of hair loss that commonly affects the frontal hairline and may involve the eyebrows. Inflammation around follicles can lead to loss of follicles, so the goal of initial care is to reduce active inflammation and limit further progression rather than simply stimulate growth.

Steroid injected into affected skin can target inflammation around individual areas. Finasteride is an oral medicine that may be discussed as part of a wider plan for suitable patients. It is not appropriate for everyone, and pregnancy-related safety needs careful discussion.

Book a dermatology assessment if the hairline is receding, the eyebrow hair is thinning, or you notice itching, burning, redness, or scaling along the edge. The clinician may examine the scalp closely, compare photographs over time, and decide whether inflammation is active.

Do not start finasteride without a clinician’s review. Tell the clinician about pregnancy, plans for pregnancy, breastfeeding, medicines, and liver or hormonal concerns. Steroid injections are performed in selected sites and may cause temporary tenderness or changes in the skin at the injection points.

Arrange an assessment promptly when hairline or eyebrow loss is progressing, particularly if the skin looks inflamed or feels sore. Seek earlier review if treatment causes marked pain, spreading redness, pus, or a persistent wound.

Ask whether your hair loss is active, which areas need anti-inflammatory treatment, whether finasteride is suitable, and how progress will be monitored with examinations or photographs.