Frontal fibrosing alopecia (FFA) and lichen planopilaris (LPP) are two of the most common types of scarring alopecia. Although they both mainly affect the scalp and hair follicles, many patients with FFA and LPP also have other health conditions. However, it has not been clear how often other health conditions occur in patients with FFA and LPP.
Study Overview
In a 2026 study, researchers combined the results of 60 previously published studies to see how common different health conditions are in patients with FFA and LPP. Overall, the combined studies included 4,499 patients with FFA and 1,370 patients with LPP.
The researchers looked at a wide range of conditions, including thyroid disease, heart and metabolic conditions such as high blood pressure and high cholesterol, other skin and hair conditions, autoimmune diseases, and mental health conditions such as depression and anxiety.
What Conditions Were Common in Patients with FFA?
In patients with FFA, the most common condition seen was androgenetic alopecia (also known as pattern hair loss), which was found in about 32% of patients.
Thyroid conditions were also common in patients with FFA. About 22% of patients with FFA had a thyroid disorder, and about 21% had hypothyroidism (an underactive thyroid). Other common conditions were high blood pressure in about 24% of patients, high cholesterol in about 18%, and obesity in about 17%.
Some skin conditions were also reported with about 20% of patients having lichen planus pigmentosus, a condition that causes dark patches on the skin, and about 14% having rosacea. Around 13% of patients with FFA also had LPP.
What Conditions Were Common in Patients with LPP?
In patients with LPP, androgenetic alopecia was also the most common condition, found in about 27% of patients. High blood pressure was found in about 21% of patients, hypothyroidism in about 19%, vitamin D deficiency in about 18%, high cholesterol in about 16%, and thyroid disorders overall in about 15%.
About 11% of patients with LPP also had lichen planus, a condition where the immune system causes inflammation that can lead to itchy, flat, purple bumps. LPP is considered a form of lichen planus that affects the hair follicles.
What About Mental Health?
Depression was seen in about 12% of patients with FFA and about 10% of patients with LPP. Anxiety was reported in about 5% of patients with FFA and about 9% of patients with LPP. However, these numbers varied between the studies included.
Were There Differences Between Men and Women?
Some conditions appeared to differ between men and women with FFA. For example, hypothyroidism was more common in women with FFA (about 26%) than in men with FFA (about 7%). Androgenetic alopecia and rosacea were more common in men with FFA. However, there were fewer men included in these studies overall.
Does This Mean FFA and LPP Cause These Conditions?
No. This study only shows how often these conditions were found in patients with FFA and LPP. It did not compare these patients to people without scarring alopecia, so it cannot show whether patients with FFA or LPP are more likely to have these conditions or whether one condition causes another.
What Does This Mean for Patients?
This study shows that many patients with FFA and LPP also live with other health conditions, especially thyroid conditions, heart and metabolic conditions, and other skin and hair conditions.
The researchers stated that their findings do not support testing every patient for every condition. Instead, they suggested that the results can help guide care based on each patient’s symptoms, age, sex, medical and family history, and planned treatment.
There were also some limitations to this study. Many of the included studies were done at specialty clinics, which may see patients with more complex disease with other health conditions. The studies included also used different methods to identify each of the health conditions, and the results varied widely between studies. Therefore, these results may not reflect every person’s experience living with FFA or LPP.
Summarized by: Sierra Schwierking, BS, MD Candidate, The Ohio State University College of Medicine, and Stephanie Trovato, MD, Board-Certified Dermatologist, Cleveland Clinic
Reference