%0 Journal Article
%T Risk factors for frontal fibrosing alopecia: A case-control study in a multiracial population.
%A Ramos PM
%A Anzai A
%A Duque-Estrada B
%A Farias DC
%A Melo DF
%A Mulinari-Brenner F
%A Pinto GM
%A Abraham LS
%A Santos LDN
%A Pirmez R
%A Miot HA
%J J Am Acad Dermatol
%V 84
%N 3
%D Mar 2021
%M 32835739
%F 15.487
%R 10.1016/j.jaad.2020.08.076
%X <B>BACKGROUND: </B>Frontal fibrosing alopecia (FFA) is a chronic cicatricial alopecia with unknown etiology and a worldwide rising incidence.<BR><B>OBJECTIVE: </B>The objective of this study was to evaluate the association of FFA with demographic and exposure factors in a Brazilian multiracial population.<BR><B>METHODS: </B>A multicenter case-control study was conducted in 11 referral centers throughout Brazil. The study was a case-control study that prospectively recruited 902 participants (451 patients with FFA and 451 sex-matched control individuals). Study participants completed a thorough questionnaire comprising variables grouped as baseline demographics, environmental exposure, diet, hormonal factors, allergies, and hair and skin care.<BR><B>RESULTS: </B>When adjusted by sex, age, menopause, and skin color, FFA was associated with hair straightening with formalin (odds ratio [OR], 3.18), use of ordinary (nondermatologic) facial soap (OR, 2.09) and facial moisturizer (OR, 1.99), thyroid disorders (OR, 1.69), and rosacea (OR, 2.08). Smokers (OR, 0.33) and users of antiresidue/clarifying shampoo (OR, 0.35) presented a negative association with FFA. There was no association with the use of sunscreen.<BR><B>CONCLUSIONS: </B>Recall bias.<BR><B>CONCLUSIONS: </B>The association with moisturizers, ordinary facial soap, and hair straightening with formalin and the negative association with antiresidue/clarifying shampoo reinforce the possibility of an exogenous particle triggering FFA.