Correlation between trichoscopic findings and disease severity in female-pattern hair loss

Abstract

Background: Female-pattern hair loss (FPHL) is a common form of hair loss in women and is referred to as androgenetic alopecia. It is characterized by diffuse reduction in hair density on the crown and frontal scalp with retention of the frontal hairline. Objective: This study aimed to examine the trichoscopic findings of FPHL and to correlate their relationship with disease severity in our tertiary care hospital. Materials and Methods: This was a prospective, observational study in which a total of thirty female patients of the age group between 18 and 45 years were included at the outpatient dermatology department within six months. The diagnosis of FPHL was based on clinical grounds. Trichoscopic evaluation was performed under the dermatoscope. Statistical significance in the difference in the outcome variables between the stages was assessed by the Fisher’s exact test. The statistical test was considered statistically significant at P < 0.05. Results: A positive correlation between clinical and trichoscopic findings with respect to disease severity was seen. HSTH > 10% was seen in all grades of FPHL. BPPS and the multi-hair follicular unit were seen in early grades of FPHL (P < 0.01); WPPS, focal atrichia, and scalp honeycomb pigmentation were seen in later grades of FPHL (P < 0.01). Conclusion: Our study showed the significance of trichoscopy in patients with FPHL. As trichoscopy may reveal early changes in hair follicle diameter before hair loss becomes clinically visible. Regular clinical and trichoscopic follow-ups are highly important to monitor disease activity and treatment tolerance.