The Association Between Frontal Fibrosing Alopecia, Sunscreen, and Moisturizers: A Systematic Review and Meta-Analysis

A systematic review and meta-analysis of 9 studies involving 1248 patients with Frontal fibrosing alopecia (FFA) and 1459 controls was conducted to investigate the association between FFA, sunscreens, and moisturizers. The results suggest that sunscreen use is associated with a 2.21 times higher likelihood of developing FFA, while the use of moisturizers is associated with a 2.09 times higher likelihood of developing FFA. The exact mechanism behind this association remains unclear, but proposed theories include an immune lichenoid reaction, generation of reactive oxygen species, hormone disruption, and attenuation of immunomodulatory effects of ultraviolet radiation. The study acknowledges limitations such as the retrospective nature of the included studies and potential selection bias. Despite these, the results highlight a significant association between sunscreen, moisturizer use, and FFA, suggesting the need for higher quality epidemiologic studies to further explore this causal relationship.