Some dermatologists are exploring the connection between skin care products and rising rates of frontal fibrosing alopecia (FFA)—a condition characterized by hair loss at the front of the scalp, predominantly affecting postmenopausal women.

A recent 2023 study suggests that FFA may be linked to facial products containing moisturizers, particularly sunscreens, based on data compiled from nine different studies.

Cases of FFA have surged in the last two decades, especially in Europe and the United States, sparking further investigation into environmental factors alongside genetic and hormonal influences.

One hypothesis is that certain ingredients in leave-on products may penetrate the skin surrounding hair follicles, inciting an immune response that can gradually damage hair follicles over time.

However, proving this link remains challenging due to the methodologies of existing studies. For instance, two UK studies found that in 2016 and 2017, researchers analyzed small cohorts of individuals with FFA. In the first study, 100 women suffering from FFA utilized more sunscreen compared to 105 women without hair loss.

Similarly, in the second study, 17 men with FFA reported using sunscreen (and sunscreen-containing moisturizers) significantly more than 73 men without symptoms.

While these findings may appear compelling, Thai researchers approached the topic with caution. In a 2021 survey, they examined 250 Asian women, of which 50 had FFA and 100 experienced significant hair loss or thinning. It was noted that individuals with hair loss employed more moisturizers and sunscreen compared to the control group.

Nonetheless, this kind of research can only indicate correlations rather than establish causation.

Another possibility is that individuals who first observe hair thinning become more focused on their appearance and may increase their usage of skin care products, rather than those products being the source of the issue.

Furthermore, sun exposure itself could also play a role, with increased sunscreen use potentially reflecting greater time spent outdoors.

A more effective way to determine the relationship would involve randomly assigning participants without hair loss to either use specific skin care products or avoid them entirely. However, is such testing ethical if these products contribute to hair loss?

For now, the majority of experts concur that the evidence is insufficient to warrant the avoidance of sunscreen, which is vital for skin cancer prevention.

The British Association of Dermatologists indicates that while the exact cause of FFA remains unknown, possible contributing factors include genetics, immune responses, and hormonal changes.

This article responds to the inquiry from Alice Carthright in Glasgow: “Does using moisturizer cause baldness?”

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