The incidence of frontal fibrosing alopecia (FFA) appears to be increasing(1-6) and response to treatment has been largely disappointing(1-3) . However, assessment of treatment interventions is confounded by slow disease progression and lack of robust means of assessing disease severity and activity. To address the latter, we have developed a validated clinical scoring system - the FFA severity index (FFASI), which provides a standardised framework for FFA assessment and patient