What type of hair loss is this? Do I have FFA? (Photos)

Question

No itching, redness or bumps on scalp. Mostly noticeable through my temples and hairline.

Ross Kopelman, DO · Answer

Frontal fibrosing alopecia (FFA) is a real possibility to consider, but it is not the only one, and I can't tell from a description alone.
Features that make FFA more likely are a hairline that is slowly moving back in a band, loss of the eyebrows, a smooth, pale or shiny skin at the hairline, and tiny red bumps or scale around the remaining hairs. It is more common in women after menopause but can occur in others. The absence of itching, redness and bumps does not exclude it, because some patients have no symptoms at all.
The more common causes of temple and hairline thinning are androgenetic alopecia (genetic pattern loss) and traction from tight hairstyles. These show hairs that become thinner and shorter, but the skin looks normal and the follicle openings remain.
A dermatologist can tell these apart with a dermatoscope: in FFA, the follicle openings disappear and there may be perifollicular redness or scale, whereas in pattern loss, hair thickness varies but openings remain. If there is doubt, a biopsy settles it.
It matters to find out early, because FFA is treated differently and may need anti-inflammatory treatment to stop progression. I would suggest a visit with a hair-focused dermatologist and clear photos of your hairline in good light.

Jeff Rapaport, MD · Answer

After looking at your global photos, it does not appear that you have Frontal, Fibrosiing Alopecia. Furthermore, your history does not include typical symptoms of itching, burning, tingling or redness. The diagnosis of Female Pattern Hair loss is suggested . A complete evaluation by a hair expert is recommended. This includes extensive history, blood work, Dermoscopy, Hair Metrix evaluation, Pull test, and possibly biopsy. There are many successful treatments including FDA approved and newer regenerative medicine approaches . Good luck.
Jeff Rapaport MD FAAD 
Realself Hall of Fame 
Castle Connolly Top Doctor

Anna Chacon, MD, FAAD · Answer

Hi there,

Thank you for sharing your concern and photos — I can completely understand how stressful it can feel to notice thinning around your temples and hairline. Hair loss in this area can have several possible causes, and it’s great that you’re paying close attention early on.

From what you described — no itching, redness, or bumps — this doesn’t strongly suggest an inflammatory type of hair loss like frontal fibrosing alopecia (FFA), which often presents with symptoms such as tightness, itching, or visible inflammation along the hairline and sometimes loss of eyebrows.

Instead, what you’re describing sounds more consistent with androgenetic alopecia (female pattern hair loss) or traction-related thinning if there’s been frequent tension from hairstyles over time. Both can lead to gradual thinning and recession at the temples without scalp irritation.

A few steps I’d recommend:

Scalp examination or dermoscopy can help confirm whether follicles are miniaturizing (as seen in pattern hair loss) or scarred (as in FFA).

Blood work can rule out underlying triggers like hormonal changes, thyroid imbalance, or low iron.

Early treatment with topical or oral therapies (such as minoxidil, spironolactone, or finasteride in some cases) can help preserve and strengthen existing hair.

The good news is that if there’s no scarring, regrowth and stabilization are very achievable with consistent treatment. You’ve done the right thing by asking about this early — identifying the pattern now gives you the best chance at maintaining healthy, full hair over time.

What type of hair loss is this? Do I have FFA? (Photos)

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