Some Moisturisers Have Been Linked With Hair Loss And Scientists Are Puzzled

In recent years, dermatologists and researchers have observed a worrying trend: a once-uncommon form of permanent hair loss known as frontal fibrosing alopecia (FFA) is becoming more frequent, particularly among women in Europe and North America. As cases continue to climb, scientists are exploring whether something as routine as using facial moisturisers and sunscreens could be an unexpected contributing factor, though the full picture remains far from clear.

What Is Frontal Fibrosing Alopecia?

FFA is a type of scarring alopecia that primarily affects the hairline and eyebrows. Unlike temporary hair shedding, FFA causes the hair follicles to become inflamed and eventually replaced by scar tissue, meaning the hair loss is usually permanent. It most commonly develops in women after menopause, though cases have also been reported in men and younger people.

Over the past two decades, diagnoses have risen sharply. While genetics, hormonal shifts, and immune system changes have long been considered the main drivers, the rapid increase suggests environmental or lifestyle factors may also be involved, and that is where skincare products have come under scrutiny.

The Emerging Link With Skincare

A major review published in 2023, which analysed data from nine separate studies, highlighted a possible association between FFA and the regular use of leave-on facial products, specifically moisturisers and sunscreens.

The theory proposed by researchers is that certain chemical ingredients found in these products may penetrate the outer layers of the skin, accumulate around the hair follicles along the hairline, and trigger a low-grade immune reaction. Over months or years, this ongoing inflammation could damage the follicles and eventually stop them from producing hair.

Several observational studies have supported this pattern:

• UK studies in 2016 and 2017: In the first, 100 women diagnosed with FFA reported using significantly more facial sunscreen than a control group of 105 women without hair loss. The second study found similar results among men: 17 men with FFA used sunscreen or moisturisers containing sunscreen far more frequently than 73 men who did not have the condition.

• A Thai study in 2021: Researchers surveyed 250 Asian women, including 50 with FFA and 100 with general hair thinning. Those experiencing hair loss reported using more moisturisers and sunscreens than those with healthy hair.

Association Does Not Equal Cause

Despite these consistent findings, scientists emphasise that correlation does not equal causation. There are several alternative explanations for the observed patterns:

• Reverse causation: It is possible that people who notice early changes in their hairline or appearance begin using more skincare products, rather than the products themselves causing the hair loss.

• Sun exposure habits: People who spend more time outdoors are more likely to use sunscreen regularly, and UV radiation itself may have biological effects on the scalp or hormones that influence FFA risk.

• Confounding factors: Lifestyle, diet, underlying health conditions, and other environmental exposures could differ between groups and be the true reason for the difference in diagnosis rates.

Proving a direct cause-and-effect relationship is extremely difficult. The gold standard of evidence, a controlled trial where some participants use specific products and others do not, raises ethical concerns: if the products were found to be harmful, it would be irresponsible to expose people to them intentionally.

Expert Advice and Current Consensus

At this stage, the evidence remains too weak and inconsistent to draw firm conclusions. Most dermatological organisations, including the British Association of Dermatologists, maintain that the exact cause of FFA is still unknown, and that genetics, immune function, and hormonal changes are the most established risk factors.

Crucially, experts strongly advise against stopping the use of sunscreen. The proven benefits of sun protection, including preventing skin cancer, premature ageing, and sun damage, far outweigh any unproven theoretical risk.

“While the hypothesis is interesting and deserves further investigation, we do not have enough evidence to tell people to avoid these products,” explains Dr. Anna Moore, a consultant dermatologist. “Stopping sunscreen use would lead to a much higher risk of serious health issues, which we know for a fact is harmful.”

Researchers are now calling for more detailed studies to identify exactly which ingredients, if any, could be problematic. Some suspect certain UV filters, preservatives, or emulsifiers may be the culprits, but this has not been confirmed.

For now, the message is one of cautious curiosity rather than alarm. FFA remains a relatively rare condition, and the vast majority of people who use moisturisers and sunscreens every day will never develop it. Still, the growing number of cases serves as a reminder that even the most common products can have complex long-term effects on the body and that science often has more to learn about how our daily routines impact our health.