No difference in relevant potential allergens in SPF-containing facial moisturizers: implications in frontal fibrosing alopecia

Abstract

Although controversial, it has been proposed that the use of leave-on facial skin care products, namely daily facial moisturizers with sun protection factor (SPF), is associated with frontal fibrosing alopecia (FFA). In accordance, several authors have previously reported on patch testing results in cross-sectional studies of patients with FFA. The aim was to survey the top-selling facial moisturizers for the prevalence of potential allergens identified in FFA patient patch testing and to then distinguish if those moisturizers containing SPF were statistically more likely to have relevant potential allergens than moisturizers without SPF. Three online retailers were surveyed for the best-selling facial moisturizers, and ingredient lists were reviewed for allergens found in FFA-patient patch testing and fragrance and botanical cross-reactors. Out of 100 unique facial moisturizers, 87 contained at least one potential allergen identified in previous patch testing results of FFA patients. There was no significant difference in the prevalence of indicated allergens in facial moisturizers with SPF in comparison to those without SPF. It does not appear that the presence of additional identified allergens in facial moisturizers with SPF explains the reported association with FFA. Further prospective, comparative studies are necessary to understand the potential role of personal cosmetic products in the development of FFA.