Frontal fibrosing alopecia in men: an association with facial moisturizers and sunscreens

Kidambi, Arpita Debroy; Dobson, K.; Holmes, Susan; Carauna, D.; Marmol, Véronique Del; Vujovic, Anja; Kaur, Manjit; Takwale, A.; Farrant, Paul; Champagne, Caroline; Harries, Matthew; Messenger, A.G.

doi:10.1111/bjd.15311

Cited by 69 publications

(51 citation statements)

References 7 publications

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“…foundations or antiageing creams). In fact, we observed a statistically significant greater use of antiageing creams in men with FFA, which is concordant with a previous study . As these molecules have been shown to influence hormonal systems, they have been categorized as endocrine disruptors (EDs).…”

Section: Discussionmentioning

confidence: 74%

“…Finally, the relatively recent identification of FFA and its apparent increasing incidence have been associated with environmental and dietary factors . Recent case–control studies in both women and men have linked the disease with facial skin care products and sunscreens, although some controversy about this association remains . Specifically, there are still some questions about the pathogenesis of FFA to be answered: (i) Are sunscreens truly associated with the disease?…”

Section: Introductionmentioning

confidence: 99%

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Risk factors associated with frontal fibrosing alopecia: a multicentre case–control study

et al. 2018

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Summary Background Frontal fibrosing alopecia (FFA) is a chronic cicatricial alopecia with an increasing incidence and unknown aetiology. Aim To identify possible environmental and hormonal factors related to FFA. Methods We conducted a multicentre case–control study paired by sex and age, and recruited 664 women (335 cases and 329 controls) and 106 men (20 cases and 86 controls). Study subjects completed an exhaustive questionnaire enquiring about pharmacological, environmental, hormonal, social, job exposure, lifestyle, drugs and diet factors to which they were exposed at least 5 years prior to the onset of the disease. Results For women, there was a statistical association between alopecia and history of pregnancy (OR = 1.6; 95% CI 1.06–2.41), use of facial sunscreen (OR = 1.6; 95% CI 1.06–2.41) and hormone replacement therapy (HRT) (OR = 1.76; 95% CI 1.11–2.8) or raloxifene (no controls exposed therefore OR was not calculated), exposure to alkylphenolic compounds (OR = 1.48; 95% CI 1.05–2.08), and presence of rosacea (OR = 1.91; 95% CI 1.07–3.39), lichen planus pigmentosus (LPP) (OR = 5.14; 95% CI 1.11–23.6) or hypothyroidism (OR = 1.73; 95% CI 1.11–2.69). For men, there was a statistical association between alopecia and use of facial sunscreens (OR = 11.6; 95% CI 1.7–80.9) or antiageing creams (OR = 1.84; 95% CI 1.04–3.23). Conclusions FFA seems to be associated with hormonal exposure (pregnancy, HRT and raloxifene), comorbidities (hypothyroidism, LPP and rosacea) and environmental factors (facial sunscreens, antiageing creams and occupational exposure). Further research is required to analyse the exact mechanism in which these environmental factors participate in the development of this alopecia.

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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Risk factors associated with frontal fibrosing alopecia: a multicentre case–control study

et al. 2018

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“…The etiology of frontal fibrosing alopecia (FFA) is controversial. Hormonal factors are thought to be involved, and recently sunscreens have been postulated as possible exogenous triggers . Less than a hundred cases of men having FFA have been reported worldwide since 1994 .…”

Section: Familymentioning

confidence: 99%

“…Hormonal factors are thought to be involved, and recently sunscreens have been postulated as possible exogenous triggers . Less than a hundred cases of men having FFA have been reported worldwide since 1994 . Furthermore, reported familial cases of FFA may point to a possible genetic susceptibility with a common environmental exposure .…”

Section: Familymentioning

confidence: 99%

Familial frontal fibrosing alopecia in two male families

et al. 2019

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“…Familial cases of FFA point to the possible contribution of hereditary factors, possibly related to androgenetic alopecia [5,6,7], while recent questionnaire-based studies performed in patients with FFA suggest environmental factors, namely a possible association between FFA and the use of facial skin care products, particularly sunscreens [8,9]. The causality of this relationship remains to be confirmed since the study may have been biased through patient and question selection as well as confounding factors that were not included in the questionnaires.…”

Section: Introductionmentioning

confidence: 99%

Cutaneous Lupus Erythematosus Presenting as Frontal Fibrosing Alopecia: Report of 2 Patients

Trüeb

Shabrawi‐Caelen

Kempf³

2017

Skin Appendage Disord

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Frontal fibrosing alopecia represents a peculiar condition with a quasi-symmetrical, marginal scarring alopecia along the frontal and temporal hairline. The condition has been associated with further histopathologic and/or clinical evidence of lichen planopilaris. Since its emergence with the original report of Kossard in 1994, frontal fibrosing alopecia has been recognized to be associated with a number of comorbidities, including lupus erythematosus. So far, respective case reports and case series have given account of frontal fibrosing alopecia with the histopathologic features of lichen planopilaris associated or overlapping with lupus erythematosus. In contrast, we present cases of histopathologically proven cutaneous lupus erythematosus presenting as frontal fibrosing alopecia with a good response to the respective treatment with oral hydroxychloroquine and/or intralesional triamcinolone acetonide.

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Frontal fibrosing alopecia in men: an association with facial moisturizers and sunscreens

Cited by 69 publications

References 7 publications

Risk factors associated with frontal fibrosing alopecia: a multicentre case–control study

Risk factors associated with frontal fibrosing alopecia: a multicentre case–control study

Familial frontal fibrosing alopecia in two male families

Cutaneous Lupus Erythematosus Presenting as Frontal Fibrosing Alopecia: Report of 2 Patients

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