Frontal fibrosing alopecia: is sunscreen the culprit? a systematic review

Hair loss is the most frequent dermatology consultation, defined as a temporary or permanent loss of hair. Frontal fibrosing alopecia is a condition that has become increasingly prevalent in recent years.

We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 flowchart, and searched three databases: PubMed, EBSCO, and Scopus. After removing duplicates, and applying inclusion, and exclusion criteria, 17 studies remained, including clinical cases, letters to the editor, and original articles.

Further investigation revealed that, while there were clinical cases that reported a correlation between the use of sunscreen and other skin care products containing titanium dioxide molecules with the onset or severity of the disease, no new original articles have found a correlation between the two variables. Currently, sunscreen use seems to be rather a consequence than a cause. However, more research is required on patients with different skin colors as well as more complex methodological studies to answer this question.

Although the methodology of the current medical literature is highly contested, it identifies sunscreen as the cause; however, higher-quality research is required to fully support this claim.