Research Links Affluence to Higher Scarring Alopecia Risk

TOPLINE:

Patients with frontal fibrosing alopecia (FFA) were significantly more likely to come from low vulnerability zip codes than those with alopecia areata (AA) in a study that also suggested that race was not an independent predictor of FFA.

METHODOLOGY:

• Researchers conducted a retrospective study of patients from 15 states treated at Johns Hopkins Hospital, Baltimore, between 2015 and 2024.
• They analyzed 147 patients with FFA and 429 patients with AA from 15 US states, with 84.2% from Maryland.
• Patients with FFA were older than those with AA (median age, 62 years vs 44 years; P < .001). White patients were most affected by FFA (51.7% vs 38.8% of Black patients), and Black patients were most affected by AA (51.5% vs 32.4% of White patients).
• Researchers matched patients’ zip codes with the US Centers for Disease Control and Prevention Social Vulnerability Index (SVI) data and evaluated differences in the level of vulnerability between the two groups.

TAKEAWAY:

• Race was not an independent predictor of FFA when controlling for socioeconomic status and age.
• A higher proportion of patients with FFA lived in low-vulnerability zip codes than those with AA (50.3% vs 34.03%; P < .001)
• Patients with FFA were significantly more likely to be from low vulnerability zip codes than patients with AA (odds ratio [OR], 1.786; P = .009).

IN PRACTICE:

“Our study suggests that FFA patients are more likely to be from affluent zip codes as determined by their SVI when compared to AA patients,” the authors wrote. “We believe, therefore, that historical emphasis on race in FFA may have been overstated due to the impact of race on socioeconomic status.”

SOURCE:

The study was led by Jiana Wyche, MHS, Department of Dermatology, Johns Hopkins School of Medicine, and was published online on May 16 in Journal of the American Academy of Dermatology.

LIMITATIONS:

The study was conducted at a single institution with most patients from Maryland, which may limit generalizability.

DISCLOSURES:

The study did not receive any funding. One author reported serving as a consultant for Pfizer, Lilly, Myovant, and Galderma; being on the advisory board for Olaplex and CP Skin Health; receiving royalties as editor of the UpToDate, and receiving research support from Janssen.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.