Frontal Fibrosing Alopecia and the Role of Cosmeceuticals in Its Pathogenesis

August 2025 in “ Cosmetics ”

Kristijan Harak, Lucija Tomić Krsnik, Marija Vukojević, Branka Marinović, Zrinka Bukvić Mokoš

frontal fibrosing alopecia scarring alopecia hormonal factors genetic factors autoimmune factors environmental factors cosmeceuticals sunscreens facial moisturizers allergens patch testing FFA hairline recession eyebrow loss body hair loss

TLDR Cosmeceuticals like sunscreens may trigger frontal fibrosing alopecia, but more research is needed.

Frontal Fibrosing Alopecia (FFA) is a complex form of scarring alopecia primarily affecting postmenopausal women, characterized by hairline recession and often linked to autoimmune diseases. The pathogenesis involves hormonal, genetic, and environmental factors, with recent studies suggesting a controversial association between cosmeceuticals, particularly sunscreens, and FFA development. A meta-analysis of 1,248 FFA patients found no link between facial moisturizers and FFA, but highlighted potential immunopathological mechanisms involving titanium dioxide in sunscreens. Despite some evidence of symptom improvement upon discontinuation of certain products, the exact mechanisms remain unclear, necessitating further research to clarify environmental triggers and improve treatment strategies.

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1 citations , June 2025 in “Journal of Clinical Medicine”

Frontal fibrosing alopecia often occurs after menopause, with delayed diagnosis and possible links to certain medications and conditions.

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February 2025

Frontal fibrosing alopecia in men is often misdiagnosed and needs better diagnostic criteria and treatments.

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Effective treatment guidelines for frontal fibrosing alopecia are still unclear.

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1 citations , November 2023 in “Contact dermatitis”

Some people with Frontal Fibrosing Alopecia may be allergic to a common sunscreen ingredient.

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2 citations , January 2023 in “Skin Appendage Disorders”

Frontal fibrosing alopecia may run in families.

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2 citations , July 2022 in “Frontiers in Medicine”

The cause of Frontal fibrosing alopecia, a type of hair loss, is complex, likely involving immune responses and genetics, but is not fully understood.

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3 citations , January 2022 in “Journal of The American Academy of Dermatology”

Using sunscreen and moisturizers may increase the chance of developing Frontal fibrosing alopecia (FFA), but the exact reason why is still unclear.

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The article concludes that understanding Frontal Fibrosing Alopecia (FFA) is crucial for effective treatment, which includes medication like 5α-reductase inhibitors and hydroxychloroquine.

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Facial care products are not linked to causing frontal fibrosing alopecia.

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Familial frontal fibrosing alopecia is rare, mostly affects women, and often occurs between sisters or mother-daughter pairs.

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Frontal Fibrosing Alopecia's cause is unclear, affects mainly postmenopausal women, and current treatments focus on stopping hair loss rather than regrowth.

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9 citations , July 2020 in “Journal of Dermatology”

Asian patients with Frontal Fibrosing Alopecia often lose eyebrow hair and respond well to combined antiandrogen or antimalarial and topical treatments.

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8 citations , July 2020 in “Clinical, cosmetic and investigational dermatology”

Excessive sun protection might cause frontal fibrosing alopecia by disrupting skin immune balance.

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35 citations , January 2020 in “Journal of the American Academy of Dermatology”

Avoiding certain allergens in personal care products may improve symptoms for some patients with lichen planopilaris or frontal fibrosing alopecia.

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4 citations , January 2020 in “Skin appendage disorders”

A woman with an unusual pattern of hair loss was confirmed to have Frontal Fibrosing Alopecia and treated with specific medications.

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8 citations , October 2019 in “International Journal of Dermatology”

The study concluded that combination therapy with topical corticosteroids and hydroxychloroquine or finasteride is effective in treating Frontal fibrosing alopecia in Asians.

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Frontal fibrosing alopecia mainly affects postmenopausal women and may be linked to thyroid hormones.

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Most patients with frontal fibrosing alopecia had facial bumps, with Hispanic/Latino and premenopausal women being more affected, suggesting a more severe condition.

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Sunscreen spray on the scalp may be linked to a type of scarring hair loss.

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30 citations , December 2017 in “Journal of The American Academy of Dermatology”

New criteria for diagnosing frontal fibrosing alopecia include specific scalp and eyebrow hair loss as major factors and other hair loss areas and hair analysis as minor factors.

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Various potential triggers may be causing the rise in frontal fibrosing alopecia, and avoiding these could help stop the disease's increase.

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Trichoscopy helps diagnose frontal fibrosing alopecia, even with unusual patterns.

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FFA's causes may include environmental triggers and genetic factors.

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