Earlier in disease course, the perifollicular erythema of lichen planopilaris (LPP) may appear gray or violaceous in darker skin tones. As LPP progresses, it can present as progressive patchy scarring alopecia on the frontal and parietal scalp, distinguishing it from the centrifugal spread of scarring alopecia on the vertex scalp seen in CCCA.

Frontal fibrosing alopecia (FFA) in darker skin tones with more tightly coiled hair can be distinguished from advanced traction alopecia by eyebrow loss and grayish to brown hyperpigmentation of the forehead.

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