Frontal fibrosing alopecia and personal care product use: a systematic review and meta-analysis.

BACKGROUND: Frontal fibrosing alopecia (FFA) is a cicatricial alopecia affecting the frontotemporal hairline. Given that this scarring, immune-mediated follicular destruction most commonly affects postmenopausal Caucasian women, researchers have postulated that there are hormonal and genetic components; however, the etiology of FFA is still unknown. Recently, dermatologists have reported cases of FFA as being potentially caused by cosmetic products, such as sunscreen and shampoo. Therefore, this systematic review and meta-analysis intend to be the first to analyze the relationship between FFA and cosmetic/personal care products and treatments, including sunscreen, moisturizer, foundation, shampoo, conditioner, hair mousse, hair gel, hair dye, hair straightening/rebonding, chemical/laser facial resurfacing, aftershave, and facial cleanser. METHODS: The Cochrane, PubMed, EMBASE, and Medline (Ovid) databases were searched for the relevant studies from the date of inception to August 2022. Case-control, cross-sectional, and cohort studies examining the effects of cosmetic/personal care product use on FFA, available in English full-text, were included. Analyses were performed using Review Manager, version 5.4. Results were reported as an odds ratio (OR) with a 95% confidence interval (CI); p values < 0.05 were considered significant. RESULTS: Nine studies were included in our quantitative analyses, totaling 1,248 FFA patients and 1,459 controls. There were significant positive associations found for FFA and sunscreen (OR 3.02, 95% CI 1.67-5.47; p = 0.0003) and facial moisturizer (OR 2.20, 95% CI 1.51-3.20; p < 0.0001) use. Gender sub-analyses demonstrated a positive association for FFA and facial moisturizer in men (OR 5.07, 95% CI 1.40-18.32; p = 0.01), but not in women (OR 1.58, 95% CI 0.83-2.98; p = 0.16). Both gender sub-analyses were significantly positive for the association with facial sunscreen (Male OR 4.61, 95% CI 1.54-13.78, p = 0.006; Female OR 2.74, 95% CI 1.32-5.70, p = 0.007). There was no association found for a facial cleanser (OR 1.14, 95% CI 0.33-1.52; p = 0.51), foundation (OR 1.13, 95% CI 0.83-1.55; p = 0.21), shampoo (OR 0.49, 95% CI 0.22-1.10; p = 0.08), hair conditioner (OR 0.81, 95% CI 0.52-1.26; p = 0.35), hair mousse (OR 1.37, 95% CI 0.75-2.51; p = 0.31), and hair gel (OR 0.90, 95% CI 0.48-1.69; p = 0.74), hair dye (OR 1.07, 95% CI 0.69-1.64; p = 0.77), hair straightening/rebonding (OR 0.88, 95% CI 0.08-9.32; p = 0.92), hair perming (OR 1.41, 95% CI 0.89-2.23; p = 0.14), facial toner (OR 0.51, 95% CI 0.12-2.21; p = 0.37), or aftershave (OR 1.64, 95% CI 0.28-9.49; p = 0.58). CONCLUSIONS: This meta-analysis strongly suggests that leave-on facial products, facial sunscreen and moisturizer, are associated with FFA. While the association with facial moisturizer did not persist when stratifying for female populations, gender sub-analyses remained significant for a facial sunscreen. There was no significant relationship found with hair products or treatments. These findings suggest a potential environmental etiology in the development of FFA, particularly UV-protecting chemicals.

The Psychological Benefits of Cosmetic Surgery.

ABSTRACT: The objective of this review is to shed light on the literature regarding the psychological impact of invasive cosmetic surgery and to discuss future implications for research and clinical practice. Articles published through October 2021 were reviewed to answer the question, "Does cosmetic surgery improve a patient's overall psychological health?" Psychological well-being was examined through the lens of body image, self-esteem, anxiety, and depression scores. The studies revealed that although cosmetic surgery seems to boost patients' body image, other crucial aspects of psychological well-being may or may not similarly benefit. Notably, factors such as a patient's preoperative mental status, level of education, type of cosmetic procedure, postoperative healing time, sex, and age play a role in determining the direction and magnitude of psychological change after surgery. Limitations include the lack of diversity in study populations and the potential role of body dysmorphic disorder. Overall, researchers have concluded that cosmetic surgery improves body image but remain in disagreement on its effects on self-esteem, anxiety, and depression.

JAK Inhibitors for Treatment of Alopecia Areata.

The advancement of genetic and preclinical studies has uncovered the mechanisms involved in the pathogenesis of alopecia areata (AA). The development of targeted therapies using small molecules blocking specific pathways for the treatment of AA is underway. By repurposing Food and Drug Administration-approved small molecule JAK inhibitors as treatments for AA, it has been demonstrated that JAK inhibitors can effectively reverse hair loss in patients with moderate to severe AA. In this review, we summarize and discuss the current preclinical and clinical studies on JAK inhibitors, as well as the prospects of using JAK inhibitors for the treatment of AA.

Case-control Association Study of Autoimmunity Associated Variants in PDCD1 and Juvenile Idiopathic Arthritis.

PURPOSE: Variants in the gene encoding Programmed Cell Death-1 (PDCD1) have been associated with susceptibility to Systemic Lupus Erythematosus and other autoimmune diseases. Given that clinically distinct autoimmune phenotypes share common genetic susceptibility factors, variants in PDCD-1 were tested for a possible association with Juvenile Idiopathic Arthritis (JIA). METHODS: Four Single Nucleotide Polymorphisms (SNPS) in the PDCD1 gene were genotyped and analyzed: rs7421861, rs11568821, rs10204525, and rs7568402 in 834 cases and 855 controls of Northern European ancestry. Each variant was examined for possible associations with JIA and then analyzed for association with JIA categories. RESULTS: PDCD1 variants showed no association with JIA in the cohort overall (rs7421861 p=0.63, rs11568821 p=0.13, rs10204525 p=0.31, and rs7568402 p=0.45). Stratification by JIA categories indicated a significant association between systemic JIA and PDCD1 rs7568402 (OR=0.53, p=0.0027), which remained significant after 10,000 permutations, but was not replicated in an independent multi-ethnic systemic JIA cohort. A nominal association between enthesitis-related arthritis and rs115668821 was also observed (OR=0.22, p=0.012). CONCLUSION: Unlike other multiple autoimmune disease associated genetic variants, there was no association between PDCD1 variants and JIA or JIA categories.