Content » Vol 101, September

Investigative Report

Hair Shaft Morphology, Elemental Composition, and Nanoparticles in Frontal Fibrosing Alopecia: A Case-control Study

Anna Lyakhovitsky, Elena Kartvelishvily, Theodoulos Drousiotis, Keren Lyakhovitsky, Sharon Baum, Aviv Barzilai
DOI: 10.2340/00015555-3891


Frontal fibrosing alopecia is a cicatricial alopecia with rising incidence. Titanium nanoparticles were suggested as a potential environmental trigger, yet this is unproven. This study assessed hair morphology, chemical composition and nanoparticles in 20 patients and 40 healthy controls using scanning electron micro­scopy and energy-dispersive X-ray spectroscopy. Morphological evaluation revealed a significantly higher degree of cuticle weathering in patients compared with controls when there were no differences in hair care routine. There were no differences in the background elemental composition, while particle analysis revealed a significant increase in particles containing titanium, chlorine, silicon, magnesium, and iron in the patient group. Titanium-containing nanoparticles showed the most significant increase, being 8.6 times greater than in controls, without relation to age and disease duration. The results indicate that patients with frontal fibrosing alopecia should be advised to avoid aggressive topical cosmetic and medical hair treatments, and refrain from using cosmetic preparations containing titanium nanoparticles.


Frontal fibrosing alopecia is a
hair disorder of unknown aetiology that is resistant to treatment and causes permanent baldness. Titanium nanoparticles in cosmetic products have been raised as a possible trigger, but their role is unproven. This study examined the structure and chemical content of hairs in patients with frontal fibrosing alopecia and compared these with normal hairs. It was found that hairs in frontal fibrosing alopecia are more weathered and contain more nanoparticles, especially titanium. Therefore we suggest that patients with frontal fibrosing alopecia should avoid, or at least reduce, aggressive hair care and topical treatments, as well as usage of cosmetic preparations containing titanium nanoparticles.

Supplementary content


Not logged in! You need to login/create an account to comment on articles. Click here to login/create an account.