Frontal fibrosing alopecia (FFA) is a scarring hair loss condition that can mimic the early appearance of androgenetic alopecia, leading to misdiagnosis in approximately 28% of hair loss cases where the wrong condition is identified initially. AI-based hair assessments, including myhairline.ai, have specific limitations when it comes to FFA that every user should understand.
What AI Can Detect
AI hair loss assessment tools analyze photos to classify hair loss patterns, typically against the Norwood Scale for androgenetic alopecia. When you upload a photo to myhairline.ai/analyze, the system can detect:
- Hairline recession patterns: Position and shape of the frontal hairline
- Density changes: Hair count per square centimeter in different zones
- Symmetry analysis: Whether recession is even on both sides
- Pattern matching: How your hair loss pattern compares to known Norwood stages
These measurements are accurate for what they measure, but they do not diagnose the underlying cause of hair loss.
What AI Cannot Detect
FFA has clinical features that require physical examination and often a biopsy to identify:
| Feature | AI Can Detect? | Why / Why Not |
|---|---|---|
| Hairline recession | Yes | Visible in photos |
| Scalp scarring | No | Requires dermoscopy or biopsy |
| Perifollicular erythema (redness) | Limited | Subtle redness may not show in standard photos |
| Loss of vellus hairs at hairline | No | Too fine for photo-based analysis |
| Eyebrow thinning / loss | Limited | Not part of standard Norwood analysis |
| Lone hairs sign | No | Requires dermoscopic examination |
| Follicular inflammation | No | Microscopic finding, biopsy required |
The critical distinction is this: androgenetic alopecia causes follicle miniaturization (hairs get thinner and shorter). FFA causes follicle destruction (hairs are permanently lost with scarring). An AI tool that measures density can detect both as "fewer hairs," but cannot distinguish between these two very different processes.
Why the Distinction Matters
Treating FFA as androgenetic alopecia leads to wasted time and money on ineffective treatments:
- Finasteride (80-90% effective for androgenetic alopecia) does not treat FFA
- Minoxidil (40-60% regrowth for androgenetic alopecia) does not address the inflammatory cause of FFA
- Hair transplant carries a high risk of failure if FFA is still active
FFA requires anti-inflammatory or immunomodulatory treatment supervised by a dermatologist. Early intervention can slow or halt the scarring process, but lost follicles cannot be recovered.
Red Flags That Suggest FFA Over Androgenetic Alopecia
If any of the following apply, seek a dermatologist evaluation before relying on an AI assessment alone:
- Band-like recession: The hairline recedes in a uniform band rather than the M-shaped pattern of androgenetic alopecia
- Eyebrow loss: Thinning or complete loss of eyebrow hair (common in FFA, uncommon in androgenetic alopecia)
- Scalp symptoms: Itching, burning, or tenderness along the hairline
- Body hair loss: Loss of arm, leg, or underarm hair
- Rapid onset: Noticeable recession developing over months rather than years
- Post-menopausal onset: FFA most commonly begins after menopause
- Pale or scarred skin: The skin where hair has been lost may appear pale, smooth, or shiny
How to Use AI Assessment Responsibly With FFA Concerns
If you suspect FFA:
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Use myhairline.ai as a documentation tool, not a diagnosis tool. Your AI assessment records your hairline position and density at a specific point in time. This data is useful for tracking changes over time and for bringing to a dermatologist appointment.
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See a dermatologist for a clinical examination and possible scalp biopsy. A biopsy is the definitive way to distinguish FFA from androgenetic alopecia.
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Do not start Finasteride or Minoxidil based on an AI assessment alone if FFA symptoms are present. These treatments do not address scarring alopecia.
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Track with AI alongside clinical care. Once diagnosed and under treatment, AI density tracking can help monitor whether your prescribed FFA treatment is stabilizing the hairline.
Get Your Baseline Assessment
Upload a photo at myhairline.ai/analyze to document your current hairline position and density. This data serves as a reference point for your dermatologist. Read our frontal fibrosing alopecia overview for more on the condition, and check am I a candidate for hair transplant to understand transplant eligibility factors.
Medical disclaimer: This article is for informational purposes only. FFA is a medical condition that requires diagnosis and treatment by a qualified dermatologist. AI-based hair assessments do not diagnose medical conditions. If you suspect scarring alopecia, seek professional evaluation promptly, as early treatment provides the best outcomes.