Female baldness caused by sunscreen filters?

We recently read the report that certain anti-sunscreen filters could promote baldness of the scalp. This would involve synthetic filters such as oxybenzone, avobenzone, and benzophenone. The condition now has a name: Frontal Fibrosing Alopecia.

This is baldness around the head, causing the hairline to recede. Dermatologists are in the dark for the time being and are cautiously pointing to certain cosmetic substances: sun filters.

Possible explanation for baldness:

‘In practice, I also see an increase in frontal fibrosing alopecia (FFA), especially in postmenopausal women and to a much lesser extent in men as well. In 8% there is a positive family history, which means that it occurs in the family.

Hair growth increase after stopping use of sunscreens

“There is now a discussion about the use of cosmetics and sunscreen and the origin of FFA. Based on observational – and research studies – the first publication in 2016, 105 of 205 women had FFA who used sunscreen at least twice a week. In 2019, they also saw a possible relationship between FFA and the use of sunscreen based on a survey study. An Australian study saw hair growth again after discontinuing sunscreen.

In 2017, a questionnaire study was done on the relationship between FFA and men, 17 men with FFA versus 73 control. Since FFA is rare in men. Use of primary sunscreens by men with FFA was significantly more common than in controls. Total 35% of men with FFA reported using sunscreen at least twice week throughout the year, compared with 4% of controls (P = 0 0012). There was no difference between the two groups in the use of hair care and other facial care products (scrubs, masks, aftershave, cleansers), medications, smoking or alcohol.

But on the other hand, a 2016 publication concluded, Frontal fibrosing alopecia: no statistically significant association was found between leave-on facial care products and sunscreen products.

Clogging hair follicle theory

It is not yet clear which cosmetic ingredients are responsible for this. One theory is that sunscreen gets into the upper part of the hair follicle (hair infundibulum).

In combination with reduced sebum production over the years, the exogenous ingredients that enter the hair are not properly removed. The result is inflammation in the hair and then scarring.”

New 2023 study

In 2023, a study found a link between sensitivity to linalool and the development of FFA. Linalool is a fragrance commonly found in skin care and cosmetic products. However, the exact relationship between linalool and FFA is not yet fully understood. While other factors, such as hormonal, immune-mediated and genetic factors, have been associated with FFA, the link between linalool and FFA is an area of ongoing research.

Can FFA be treated?

Here are some treatments dermatologists may use to treat FFA:

1. Anti-inflammatory treatments: Corticosteroids, both topical and injections, are often used to reduce the inflammation and fibrosis associated with FFA.
2. Immune system suppressant medications: Medications such as hydroxychloroquine and mycophenolate mofetil may be prescribed to modulate the immune system and reduce inflammation.
3. 5-alpha reductase inhibitors: Medications such as finasteride or dutasteride, which are often used for androgenetic alopecia, can sometimes help reduce hair loss from FFA.
4. Retinoids: Topical or oral retinoids may be considered to improve skin health and reduce inflammation.
5. Hair Growth Stimulants: Minoxidil lotion 2 x per day, applied to the scalp, can help stimulate hair growth in the affected areas.

Although the treatments mentioned can help, their effectiveness is often limited and variable. Not all patients respond equally well to the same treatment.

What about hair transplantation?

Hair transplantation can be effective for certain types of hair loss, such as androgenetic alopecia, known as hereditary baldness. However, with Frontal Fibrosing Alopecia (FFA) the situation is more complicated.

Why is hair transplantation often ineffective with FFA?

• Scarring: FFA causes scarring of the hair follicles, causing them to be destroyed and unable to be reactivated, even with hair from other areas.
• Active inflammation: Because FFA is an active inflammatory disease, persistent inflammation can cause transplanted hairs to fall out again.

When is hair transplantation possible?

• Disease stabilization: If FFA is stabilized in the early phase without active inflammation, hair transplantation can be considered to restore the hairline.
• Combination therapy: Sometimes a hair transplant can be combined with other treatments, such as medication, to improve results.

While you are here

Hair loss is any form of hair loss on the body. In this overview we focus on hair loss from the hairy scalp and face. To help you find out which types of hair loss there are, you can find an overview of many different types and causes of hair loss here.

Hair loss is often associated with several causes at the same time. Therefore, it can be very difficult to get a diagnosis that explains all your complaints, and also successfully treat your hair loss. Hair loss is almost always harmless, but it can cause serious psychological problems. That is why it can be nice to know which diagnosis applies to you and prevent hair loss if possible. Therefore, always consult your doctor if you are concerned or have psychological complaints. The doctor will ask you many questions and examine the scalp in detail to find out the various causes and make the most appropriate diagnosis and treatment. Here is an overview of the most common forms of hair loss.