Concomitant Allergic Contact Dermatitis and Frontal Fibrosing Alopecia: A Potential Trigger for Relapse or Onset?

Environmental particles, such as titanium dioxide found on hair shafts of FFA patients, are hypothesized to contribute to FFA through photocatalytic activity causing tissue damage and inflammation. Studies indicate a higher use of facial moisturizers and sunscreens among FFA patients, with frequent positive patch test reactions to allergens in personal care products. These allergens may disrupt hair follicle immune privilege, leading to inflammation, fibrosis, and follicular destruction. Understanding the role of environmental factors in FFA pathogenesis may improve management strategies, emphasizing allergen avoidance and targeted treatments.