FFASI Calculator

Frontal Fibrosing Alopecia Severity Index — Holmes, Ryan, Young & Harries, 2016

Purpose
Standardised severity score for frontal fibrosing alopecia that weights hairline recession most heavily and adds frontal-band inflammation/density, non-scalp hair loss and associated lichen planus features.
Population
Adults with frontal fibrosing alopecia (validated in an image-based exercise by UK dermatologists; the measured-band variant, FFASI-B, was not validated in the original study).
Formula
FFASI = hairline recession (4 sections × 0–20) + frontal band (0/2/4) [scalp max 84] + other hair (5 sites × 0–2) + associated features (6 × 0/1) [max 16]  ·  Total 0–100
Severity thresholds
No validated severity bands have been published for FFASI. Report the total and the scalp / non-scalp subtotals and track change over time.
📏 Hairline recession (4 sections)

Grade the width of the band of alopecia (from the original hairline to the current hairline) in each section. Each grade scores 4 points: no loss = 0, grade 1 = 4, grade 2 = 8, grade 3 = 12, grade 4 = 16, grade 5 = 20.

1 ≤ 1 cm 2 1–2.9 cm 3 3–4.9 cm 4 5–7.9 cm 5 ≥ 8 cm
Hairline recession subtotal 0 / 80
🔥 Frontal band — inflammation and density

Assess the band of skin along the frontal hairline: 0 = no inflammation and normal density · 2 = inflammation or reduced density · 4 = both.

Frontal band score 0 / 4
👁️ Alopecia at other sites

0 = no loss · 1 = partial loss · 2 = total loss.

Other-site hair loss subtotal 0 / 10
🧩 Associated features

1 point each if present.

Associated features subtotal 0 / 6
📚 References
  1. Holmes S, Ryan T, Young D, Harries M. Frontal Fibrosing Alopecia Severity Index (FFASI): a validated scoring system for assessing frontal fibrosing alopecia. Br J Dermatol. 2016;175(1):203–7. doi:10.1111/bjd.14445
  2. Vañó-Galván S, Molina-Ruiz AM, Serrano-Falcón C, et al. Frontal fibrosing alopecia: a multicenter review of 355 patients. J Am Acad Dermatol. 2014;70(4):670–8. doi:10.1016/j.jaad.2013.12.003
  3. Saceda-Corralo D, Moreno-Arrones ÓM, Fonda-Pascual P, et al. Development and validation of the Frontal Fibrosing Alopecia Severity Score. J Am Acad Dermatol. 2018;78(3):522–9. doi:10.1016/j.jaad.2017.09.034
  4. Porriño-Bustamante ML, Fernández-Pugnaire MA, Arias-Santiago S. Frontal fibrosing alopecia: a review. J Clin Med. 2021;10(9):1805. doi:10.3390/jcm10091805
Clinical decision support only. This tool is intended to assist clinical assessment and does not replace professional judgment. Always interpret results in the context of the individual patient.