Trichoscopic features in female pattern hair loss- one year hospital based cross-sectional study

Abstract

INTRODUCTION: Patterned hair loss (PHL) is a common cause of hair loss in both men and women, and a condition for which patients commonly seek dermatologist consultation. PHL in females is known as female pattern hair loss (FPHL) and is frequently responsible for psychological distress and impaired social functioning. FPHL is a non-scarring alopecia characterised by miniaturisation of the hair follicles, wherein terminal hairs are converted into vellus hairs, resulting in a decrease in hair density and thinning of hair over the frontal, mid-frontal, and vertex regions while retaining the frontal hair line. The exact patho-physiology of female pattern hair loss is unknown with genetic factors, hair cycle defects, hormonal and environmental factors being implicated in its cause. It may occur alone or may be a part of constellation of androgen related conditions. Early diagnosis and initiation of treatment are desirable because treatments are more effective to avoid the progression of hair loss than stimulating regrowth. Typically, a diagnosis of FPHL can be confirmed by review of a patient's medical history and a physical examination, scalp biopsy is diagnostic but usually not required. Trichoscopy- “dermoscopy of scalp” is a non-invasive method (vs. scalp biopsy) for diagnosis of hair loss using videodermoscopy of hair and scalp at higher magnifications (10x–140x) and allows measurement of hair diameter diversity (HDD), which is a characteristic feature of FPHL, recently termed as “Anisotrichosis”. Trichoscopy has been widely used as a diagnostic as well as a prognostic tool to measure anisotrichosis in cases of overt androgenetic alopecia (AGA) and FPHL. Trichoscopy can also be used as a tool to diagnose FPHL in early cases. OBJECTIVE: To study the trichoscopic features of female pattern hair loss.