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Living with Focal facial dermal dysplasia type III

A rare condition with scar-like dents on both temples at birth and variable facial features, linked to the TWIST2 gene.

Understanding Focal facial dermal dysplasia type III

Focal facial dermal dysplasia type III (FFDD3) is a rare skin and facial condition with scar-like dents on both temples from birth.

Facial features vary and may include double or missing eyelashes, slanted eyebrows, and a flat or rounded nose tip. Others include a low hairline, sparse hair, loose skin, skin folds at the inner eyes, low-set ears, and eyelid or eye surface inflammation.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Scar-like dents on the temples
  • Double or missing eyelashes (distichiasis)
  • Slanted, sparse eyebrows
  • Flat or wide nasal bridge
  • Sparse hair and loose skin
  • Prematurely aged appearance

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include genetic specialists and skin, hair, and nail specialists.

  3. Consider genetic testing

    Changes in TWIST2 are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

  4. Connect with expert centers

    National Foundation for Ectodermal Dysplasias may keep lists of experts for this condition.

Care & treatment

Care team
Genetic specialists (geneticists); Skin, hair, and nail specialists (dermatologists)
Expert care
Expert lists: National Foundation for Ectodermal Dysplasias
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with National Foundation for Ectodermal Dysplasias and other patient organizations
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Should we have genetic testing for the TWIST2 gene?
How can eyelid and eye irritation be managed?
Which specialists should follow skin and facial concerns?

Quick facts

Symptoms usually startduring Pregnancy and as a Newborn
InheritanceAutosomal Dominant, Autosomal Recessive
GenesTWIST2

Changes in the TWIST2 gene cause it. GARD says it can be inherited in an autosomal dominant or autosomal recessive way.

GeneticSkin

Also known as: bitemporal forceps marks syndrome; ffdd type 2; ffdd type iii; ffdd3; focal facial dermal dysplasia 3; focal facial dermal dysplasia 3, setleis type

Patient organizations

Source: NIH GARD · Focal facial dermal dysplasia type IIIGARD ID 121 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Focal facial dermal dysplasia type III.

Explore the Focal facial dermal dysplasia type III blog

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