A Clinico-Trichoscopic Analysis of Hair Density and Diameter Variability in Relation to Severity Grading of Female Pattern Hair Loss

CONTEXT: Hair loss is a common complaint among Indian women. For female pattern hair loss (FPHL), diagnosis is primarily clinical. In the early stages, it can be confused with other conditions. Histopathology is the diagnostic method of choice but requires multiple biopsies and can be disfiguring. Trichoscopy is an alternative noninvasive, rapid tool. AIM: The aim of this study is to study the hair density and hair diameter variance in relation with severity grading of FPHL. SETTINGS AND DESIGN: Cross-sectional study. MATERIALS AND METHODS: Ninety women aged 18 years and above were included in this cross-sectional study conducted at the dermatology department of Bangalore Medical College and Research Institute. Trichoscopic examination was done with a videodermoscope (Firefly DE300) at 20 and 70-fold magnification. Only those patients who met the trichoscopic diagnostic criteria for FPHL were included. STATISTICAL ANALYSIS USED: Descriptive statistics, ANOVA, and Spearman's correlation test for fitness of good, using Microsoft Excel data analysis tools. RESULTS: Increase in disease severity from grade one to grade three positively correlated with a decrease in hair density over the frontal scalp (P < 0.001) and the occipital scalp (P < 0.001), decrease in average hair shaft diameter over both frontal and occipital scalp (P < 0.001). CONCLUSION: Trichoscopic tools, particularly hair density and hair diameter variance over both frontal and occipital scalp can be useful to help determine FPHL disease severity and its progression.