Correlation of Trichoscopic Findings with Severity in Androgenetic Alopecia

Background: Androgenetic Alopecia (AGA) refers to the appearance of common non-scarring progressive loss of terminal hair. Trichoscopy shows a magnified view of the hair shafts and hair follicle openings and helps us to diagnose, prognosticate and determine the disease severity.

Aims: The aim of the study was to identify the trichoscopic findings in patients with androgenetic alopecia and associate these findings with disease severity.

Methods: This was a cross-sectional analytical study of both male and female patients with AGA. The Hamilton Norwood staging was used in males and Ludwig's staging was used in females. The NC 2 Heine Dermoscope was used to assess the scalp and a 64 MP rear camera was used for the photographic assessment. A Chi-square test was performed to find out the association between the stage of alopecia and trichoscopic findings.

Results: A total of 63 patients were assessed in this study. Trichoscopic examination showed Hair Shaft Heterogeneity (HSTH) in all patients of AGA. Scalp honeycomb pigmentation and brown peripilar signs were seen in more than half of the patients. The white peripilar sign was associated with advanced stages in both male and female patients, (P = 0.015) and (P = 0.038) respectively. Focal atrichia was also associated with advanced stages in both male and female patients, (P = 0.001) and (P = 0.05) respectively.

Conclusion: HSTH was the characteristic trichoscopic feature of AGA. White peripilar sign and focal atrichia correlated with the severity of the disease. Trichoscopy-based assessment can be used to individualise the treatment options and counsel the patients regarding prognosis.