Document Type

Conference Proceeding

Publication Date


Publication Title

J Am Acad Dermatol


Frontal fibrosing alopecia (FFA) is an immune-mediated cicatricial alopecia. Skin care products including sunscreen were suggested to influence disease pathogenesis. Given the conflicting data, the aim of this study is to provide a quantitative summary on this topic. A systematic search surveying PubMed database was conducted in August 2021. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. The study was prospectively registered in Prospero (ID: 273840). The pooled effect size is presented as odds ratio (OR) with 95% confidence interval (CI). A total of 87 articles were identified; 9 articles were included. Using the Newcastle Ottawa scale (NOS), the quality of studies ranged from 5 to 7, suggestive of moderate quality. 1248 patients in the published literature had FFA (mean age: 58.9, 95.7% female) and were compared with 1459 control subjects (mean age: 56.9, 89.8% female). Six (66.67%) studies assessed the use of sunscreen and moisturizers 5 years before the onset of FFA. Nine studies evaluated the association between sunscreen and FFA (n = 9); the pooled OR was 1.45 95%CI [1.11-1.90], P =.0068. For the 8 studies exploring the relationship between facial moisturizers and FFA, the pooled OR was 1.26 (95% CI 1.10-1.43), P =.006. The results of this study suggest that both sunscreen and moisturizers likely increase the risk of FFA by 45% and 26% respectively. Due to lack of randomized controlled trials and small number of studies, the causality of this association could not be ascertained. As such, high-quality studies are needed.





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