Frontal fibrosing alopecia treatment in Valencia

This is an inflammatory scarring alopecia in which the immune system damages the follicular stem-cell area. Distribution is characteristic: progressive, generally symmetrical recession of the frontal hairline and temples, with loss of follicular openings in scarred areas. Eyebrow loss is very common and sometimes precedes hairline recession. Itching, burning or tightness may occur, although many people have no discomfort.

It mainly affects postmenopausal women, but increasingly also premenopausal women and men. Other hair conditions frequently coexist, such as androgenetic alopecia, requiring separate assessment of each component.

Treatment acts on remaining follicles and inflammation ahead of the scarred edge, rather than smooth areas: destruction before treatment is irreversible. Progression speed varies, so early objective assessment matters. Where eyebrows still retain follicles, injections may help preserve them, with variable results and a greater chance of response with earlier action.

Seek advice promptly for:

• frontal or temple recession, especially with a band of smooth or lighter skin;
• thinning or loss of one or both eyebrows without an obvious cause;
• loss of sideburns;
• isolated hairs ahead of a receding hairline;
• persistent redness, scaling, itching or burning at the frontal edge.

Diagnosis relies on recession pattern, eyebrow loss, scarred skin appearance and digital trichoscopy, showing absent follicular openings in scarred areas and redness and scaling around hairs at the active edge. For follow-up, we suggest standardised photographs and hairline measurements: daily mirror checks cannot distinguish a few millimetres of progression.

There is no cure or single protocol: the aim is to suppress inflammation and stabilise disease. Depending on the case, the plan combines gentle scalp care without traction, prescription anti-inflammatory topical treatment, anti-inflammatory injections through mesotherapy at the frontal edge or eyebrows when active, and oral medication or other systemic treatments. Response is assessed over months rather than days, comparing photographs and measurements.

What treatment cannot do

Treatment cannot restore hair in scarred areas or predictably return the original hairline: the aim is to stop or slow recession. The condition cannot be cured and may stabilise, reactivate or progress despite treatment. Oral medication and other systemic treatments do not stabilise every case, and growth-stimulating treatment alone does not stop scarring inflammation. Close follow-up therefore assesses response and guides adjustments.

The first visit confirms whether scarring alopecia is present and identifies areas retaining viable follicles. We review onset and progression speed, hormonal and autoimmune history, symptoms and pregnancy intentions, relevant before certain treatments, and examine the frontal hairline, temples, eyebrows and remaining scalp. We design a stabilisation-focused plan with timescales and monitoring. It is part of our hair medicine service in Valencia, available in Spanish, English and Italian. You can meet the medical team before your visit.

Consultation, diagnosis and follow-up are usually covered by health insurance policies, subject to each insurer’s conditions and policy type. Digital trichoscopy and supportive procedures such as PRP or scalp mesotherapy are not usually covered and are paid for separately. We confirm this when you book.