Article Summary by Jessica Brown-Korsah | MD Candidate |Case Western Reserve University School of Medicine

Frontal fibrosing alopecia (FFA) is a specific form of scarring alopecia that primarily affects women, leading to the loss of hairline, thinning of the skin, and the development of prominent facial veins in the affected area. A recent article published in January 2023 by Sun et al. delves into the treatment of facial veins in patients diagnosed with FFA.

Between 2006 and 2020, a total of 128 patients with FFA were diagnosed at the Cleveland Clinic. Out of this group, approximately 23% (29 out of 128) exhibited noticeable facial veins, including superficial temporal veins (found on the side of the head), terminal branches of supratrochlear veins, and veins on the upper forehead. It is important to note that while the use of topical steroids can sometimes lead to skin thinning and prominent veins, some patients developed these changes without even receiving steroid treatment. This suggests that the prominence of facial veins in FFA is primarily attributed to the scarring process inherent to the condition.

In the study, five out of the 29 patients with prominent facial veins underwent treatment using a long-pulse Nd:YAG laser. The Nd:YAG laser emits a specific wavelength of light that effectively targets blood vessels and can be used to treat vascular lesions. The patients reported significant improvement in their appearance with minimal side effects. These findings demonstrate that Nd:YAG laser therapy holds promise as a safe and effective treatment option for addressing prominent facial veins in individuals with FFA.

In summary, FFA is a type of scarring alopecia that predominantly affects women, resulting in the loss of hairline, thinning of the skin, and the development of prominent facial veins. The scarring process within FFA is believed to be responsible for the facial vein prominence. The study by Sun et al. highlights the successful use of long-pulse Nd:YAG laser therapy in improving the appearance of facial veins in FFA patients.

See full article here.

References

1. Tosti A, Piraccini BM, Iorizzo M, Misciali C. Frontal fibrosing alopecia in postmenopausal women. Journal of the American Academy of Dermatology. 2005;52(1):55-60. doi:10.1016/j.jaad.2004.05.014
2. Sun L, Mehrabi S, Khetarpal S, Piliang M. Characterization and treatment of prominent facial vasculature in the setting of frontal fibrosing alopecia. Journal of the American Academy of Dermatology. 2023;88(1):174-176. doi:10.1016/j.jaad.2021.12.051
3. Sun L. Supplemental Figure for JAAD-D-21-01160R1. 2021;1. doi:10.17632/dprrxx3pdb.1