Value of Trichoscopy Versus Trichogram for Diagnosis of Female Androgenetic Alopecia

BACKGROUND: Female androgenetic alopecia (FAGA) is a frequent cause of hair loss in women. Standard diagnostic methods are clinical inspection, pull test, and trichogram. It has been suggested that scalp dermoscopy (trichoscopy) revealing diversity of hair shaft diameter >20% is diagnostic of FAGA. OBJECTIVE: To evaluate the value of trichoscopy as compared to the trichogram for the diagnosis of FAGA. PATIENTS AND METHODS: Retrospective case study of 162 women with the complaint of hair loss who underwent trichoscopic examination and trichograms. RESULTS: Of all women diagnosed FAGA (55%), 62% were diagnosed by trichogram, 72% by trichoscopy with a cut-off point of 20%, and 100% irrespective of the degree of diversity of hair shaft diameter. CONCLUSIONS: Trichoscopy is a valuable and superior method to the trichogram for diagnosis of FAGA, especially in early cases, with the highest yield irrespective of the suggested cut-off of 20% diversity of hair shaft.