Alopecia Frontal Fibrosante Casos y Controles

Background:Frontal fibrosing alopecia (FFA) is a primary scarring alopecia of unclear etiology. Recent studies suggest a possible association with cosmetic and hair care practices, though the role of frequency and timing remains underexplored.Methods:We conducted an observational, analytical case-control study including 115 patients with FFA and 112 age- and sex-matched controls without scarring or androgenetic alopecia. Participants were treated at the Hospital Italiano de Buenos Aires between January 2015 and April 2024. All provided data on current cosmetic and hair care habits; FFA cases also reported habits from five years prior to symptom onset. Results:Use of leave-in hair products at least once per week (OR ≈ 5) and undergoing hair treatments at least once per year (OR ≈ 3) were significantly associated with FFA. In contrast, daily hair washing showed a significant protective effect (p < 0.01), while washing three times per week did not reduce risk. No significant association was found between facial sunscreen use and FFA. Habits reported five years before diagnosis were statistically similar to current habits among FFA cases.Conclusion:This study identified a strong association between FFA and the use of leave-in hair products and hair treatments, and a protective role of daily hair washing. These findings suggest that cumulative exposure to certain substances present in cosmetic practices may contribute to FFA pathogenesis. Further multicenter, prospective studies are needed to clarify causal relationships and the role of contact allergens.