SCOPUS: le.jinfo:eu-repo/semantics/publishe

Carauna, D.

Champagne, C.

Del Marmol, V.

Dobson, K.

Farrant, P.

Harries, M.

Holmes, S.

Kaur, M.

Kidambi, A.D.

Messenger, A.

Takwale, A.

Vujovic, A.

White Rose Research Online

This is a repository copy of Frontal fibrosing alopecia in men: an association with leave-on facial cosmetics and sunscreens.White Rose Research Online URL for this paper:http://eprints.whiterose.ac.uk/112355/Version: Accepted VersionArticle:Kidambi, A.D., Dobson, K., Holmes, S. et al. (9 more authors) (2017) Frontal fibrosing alopecia in men: an association with leave-on facial cosmetics and sunscreens. British Journal of Dermatology, 175. p. 46. ISSN 0007-0963 https://doi.org/10.1111/bjd.15311eprints@whiterose.ac.ukhttps://eprints.whiterose.ac.uk/Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version - refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher’s website. Takedown If you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. Accepted ArticleThis article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/bjd.15311 This article is protected by copyright. All rights reserved. Received Date ┺ どに┽Jul┽にどなは Revised Date   ┺ どぱ┽Nov┽にどなは Accepted Date ┺ にひ┽Nov┽にどなは Article type      ┺ Research Letter   Frontal fibrosing alopecia in men  an association with facial moisturisers and sunscreens  Authors A┻ Debroy┽Kidambiな┸ K┻ Dobsonな┸ S┻ (olmesに┸ D┻ Caraunaに┸ V┻ Del Marmolぬ┸  A┻ Vujovicぬ┸ M┻ Kaurね┸ A┻ Takwaleの┸ P┻ Farrantは┸ C┻ Champagneば┸ M┻ (arriesぱ┸  A┻ G┻ Messengerな  Royal (allamshire (ospital┸ Sheffield UKな┸  Southern General (ospital┸ Glasgow┸ UKに (opital Erasme┸ Université Libre de Bruxelles┸ Brussels┸ Belgiumぬ Solihull (ospital┸ Solihull┸ UKね Gloucestershire Royal (ospital┸ Gloucester┸ UKの Brighton ┃ Sussex (ospitals┸ Brighton┸ UKは The Churchill (ospital┸ Oxford┸ UKば University of Manchester┸ Salford Royal Foundation Trust┸ Salford┸ UKぱ   Correspondig author mail id┺ kkmaにどぬはｈhotmail┻com  Dear Sir Frontal fibrosing alopecia ゅFFAょ was first described by Kossard in なひひね in は postmenopausal women┻な FFA remained rare during the なひひどs but in the last など┽なの years it has become increasingly common┸ a phenomenon observed worldwide┻ The recent onset and apparent rising incidence of FFA suggest involvement of an environmental factorゅsょ in the aetiology┻ We previously reported a questionnaire study in women with FFA that asked about a wide range of medical┸ social and environmental exposures┻ The results suggested an association between FFA and leave┽on facial products┸ including moisturisers and sunscreens┻に (owever┸ although the regular use of moisturisers was greater in women with FFA┸ these products are used by most women and we were unable to show a significant difference in their use between women with FFA and similarly┽aged control subjects┻ The use of primary sunscreens was significantly greater amongst women with FFA compared to controls but we were not able to assess whether subjects were also exposed to sunscreens from other sources┻  We have therefore repeated our questionnaire study in men with FFA as we anticipated that the use of leave┽on facial skin care products would be lower than in women┻  Accepted ArticleThis article is protected by copyright. All rights reserved. As FFA is rare in men subjects were recruited from across the UK and one case was recruited from Belgium┻ )n all cases the diagnosis was made by a clinician with special expertise in hair disease and supported by histology in most cases┻ The clinical diagnosis was based on scarring alopecia affecting the frontal hairline causing recession of the hairline┻ Additional features included loss of eyebrows┸ follicular erythema of the frontal hairline and loss of sideburn【beard hair┻ Male control subjects aged between ぬの┽ぱど years were recruited from three sites ゅSheffield┸ Salford┸ Glasgowょ┻ Subjects completed a questionnaire similar to that used in our female study but inviting more detailed information on the use of facial skin and hair care products┻ Male FFA patients were asked about the timing and distribution of hair loss but otherwise the questionnaires completed by both groups were identical┻    Seventeen men with FFA and ばぬ control subjects were recruited┻ The mean age of onset of hair loss in the FFA subjects was のね┻の ゅrange ぬの ‒ ばばょ┻  All had loss of hair from the frontal hairline and なは ゅひねガょ had lost eyebrows┻ Twelve men ゅばなガょ reported loss of hair from the beard and thirteen ゅばはガょ reported loss of hair from the limbs┻ All men with FFA reported using facial moisturisers compared to ねどガ in the control group┻ Facial moisturisers were used at least twice a week by ひねガ of FFA subjects but by only ぬにガ of controls ゅpジど┻どどどなょ ゅTableょ┻ Sixteen subjects reported using moisturisers for a period consistent with their use prior to the onset of FFA┻ The use of primary sunscreens by men with FFA was significantly more common than by controls┻ ぬのガ of men with FFA reported using a sunscreen at least twice a week all year round compared to ねガ of control subjects ゅpサど┻どどなにょ┻ When moisturisers containing sunscreen chemicals were included in the analysis at least ばなガ of men with FFA applied a product containing a sunscreen at least twice a week all year round compared to ななガ of controls ゅpジど┻どどどなょ┻  One man with FFA applied a sunscreen product once a week all year round┻ Four men with FFA did not provide adequate information on the products they used to assess their sunscreen exposure┻ There was no difference between the two groups in the use of hair care and other facial skin care products ゅscrubs┸ masks┸ aftershave┸ cleansersょ┸ medications┸ smoking and alcohol┻  Although the numbers are small these results support the conclusion from the previous female studyな that there is an association between FFA and the use of facial moisturisers and sunscreens┻ The time course of sunscreen use by the population does seem to parallel the apparent increase in the incidence of FFA and to some extent the predominant distribution of FFA accords with the usual sites of moisturiser and sunscreen application┻ On the other hand┸ a causative role for leave┽on facial products does not readily explain the frequency of hair loss on the limbs and occipital hairline seen in some men and women┸ or the occasional association with cutaneous or mucosal lichen planus┻ぬ Although the frequency of use was significantly greater than in control subjects┸ we have also not shown that all men with FFA were applying sunscreens┸ a pre┽requisite were this to be the cause of FFA┻ A study from Scotland found that women with FFA had a higher degree of affluence than expected┻ね There is an association between sunscreen use and higher socio┽economic statusの┸は and it is possible our results reflect this demographic rather than indicating a causative link┻ )n summary┸ our results in a cohort of men with FFA support a previous suggestion that there is an association between FFA and the use of leave┽on facial skin care products and Accepted ArticleThis article is protected by copyright. All rights reserved. sunscreens┻ This may indicate a causal role but our results do not provide proof┻ The absence of a test that provides more conclusive evidence of cause is a significant limitation and the development of such a test should be a focus of future research into this increasingly common disorder┻   References な┻ Kossard S┻ Postmenopausal frontal fibrosing alopecia┻ Scarring alopecia in a pattern distribution┻ Arch Dermatol. なひひね┹なぬど┺ばばど┽ばばね┻ に┻ Aldoori N┸ Dobson K┸ (olden CR┸ McDonagh AJ┸ (arries M┸ Messenger AG┻ Frontal fibrosing alopecia┺ possible association with leave┽on facial skin care products and sunscreens┹ a questionnaire study┻ Br J Dermatol. にどなは┹なばの┺ばはに┽ばはば┻ ぬ┻ Vañó┽Galván S┸ Molina┽Ruiz AM┸ Serrano┽Falcón C┸ et al┻ Frontal fibrosing alopecia┺ a multicenter review of ぬのの patients┻ J Am Acad Dermatol. にどなね┹ばど┺はばど┽はばぱ┻ ね┻ (olmes S┸ MacDonald A┻ Frontal fibrosing alopecia┻ J Am Acad Dermatol. にどなね┹ばな┺のひぬ┽のひね┻ の┻ (an C┸ Lim Y(┸ (ong YC┻ Ten┽year trends in urinary concentrations of triclosan and benzophenone┽ぬ in the general U┻S┻ population from にどどぬ to にどなに┻ Environ Pollut. にどなは┹にどぱゅPt Bょ┺ぱどぬ┽ぱなど┻ は┻ Kang (S┸ Ko A┸ Kwon JE┸ et al┻ Urinary benzophenone concentrations and their association with demographic factors in a South Korean population┻ Environ Res. にどなは┹なねひ┺な┽ば┻     Accepted ArticleThis article is protected by copyright. All rights reserved. Table   Reported use of skin and hair care products by FFA and control subjects┻      FFA Controls  Number of subjects なば ばぬ  Age ゅmean┸ rangeょ はぬ┻な ゅねに┽ぱどょ のひ┻な ゅぬば┽ばひょ  Age at onset of hair loss ゅmean┸ rangeょ のね┻の ゅぬの┽ばばょ N【A   nサ ガ nサ ガ p Facial moisturiserな なは ひね┻な にぬ ぬに┻ね ジど┻どどどな Primary sunscreenに は ぬの┻ぬ ぬ ね┻な ど┻どどなに Sunscreenに なに ばど┻は ぱ なな┻ど ジど┻どどどな Facial cleanserな ね にぬ┻の の ば┻ど ど┻どはは Facial scrubな ど ど ど ど  Facial maskな ど ど ど ど  Aftershaveな ば ねな┻に にぱ ぬひ┻ね な┻どどど Shampooな なぬ ばは┻の はに ぱね┻ひ ど┻にはば Conditionerな ね にぬ┻の なぬ なぱ┻ぬ ど┻ばぬぬ (air sprayな な の┻ひ に に┻ひ ど┻ねばひ (air mousseな ど ど ど ど  (air gelな に なな┻ぱ など なぬ┻ば な┻どどど (air dyeぬ に なな┻ぱ ぬ ね┻ぬ ど┻にのの   な Twice a week or more frequently に Twice a week or more frequently all year round ぬ At least once a year Sunscreen includes exposure to sunscreen chemicals in primary sunscreens and moisturisers┻ Analyses were performed after excluding subjects who failed to answer the question┻ Frequencies in FFA and control subjects were compared using Fisher╆s Exact Test┻       

Frontal fibrosing alopecia in men: an association with leave-on facial cosmetics and sunscreens

Debroy Kidambi, A.

Kaur, M. R.

Takwale, Anita

Messenger, A. G.

The University of Manchester - Institutional Repository

Frontal fibrosing alopecia in men:an association with facial moisturizers and sunscreens

A. Debroy Kidambi

K. Dobson

S. Holmes

D. Carauna

V. Del Marmol

A. Vujovic

M.R. Kaur

A. Takwale

P. Farrant

C. Champagne

M. Harries

A.G. Messenger

Crossref

British Journal of Dermatology

Frontal fibrosing alopecia in men: an association with facial moisturizers and sunscreens

Debroy Kidambi, Arpita

Champagne, Caroline

Harries, Matthew

Messenger, Andrew

Dobson, Kathy

Holmes, Susan

Del Marmol, Véronique

Vujovic, Anja

Kaur, Manjit

DI-fusion

https://eprints.whiterose.ac.uk/112355/1/Debroy-Kidambi_et_al-2017-British_Journal_of_Dermatology.pdf

Frontal fibrosing alopecia in men: an association with leave-on facial cosmetics and sunscreens

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White Rose Research Online

The University of Manchester - Institutional Repository

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