Analyzing Alopecia Areata with the Trichoscopic Eye: Markers of Disease Severity, Disease Activity, Novel Findings and Association with Trichotillomania

May 2025 in “ Apollo Medicine ”

Samridhi Gulati, Sharang Gupta, Anjana Rajenesh, Dimple Chopra, Preeyati Chopra

alopecia areata trichoscopy black dots cadaverised hair exclamation mark hair vellus hair leucotrichia yellow dots white patches cotton-wool like patterns honeycomb pigmentation trichotillomania

Studysummary This study found that trichoscopy can be a helpful, noninvasive tool for identifying specific patterns that correlate with the clinical activity and severity of alopecia areata, enhancing its diagnosis and monitoring. Our plain-language summary of this paper — not a Tressless recommendation.

This study involving 160 treatment-naïve patients with alopecia areata (AA) highlights the utility of trichoscopy as a noninvasive diagnostic tool to assess disease activity and severity. Key trichoscopic patterns such as black dots, cadaverised hair, and exclamation mark hair were associated with increased disease activity, while features like vellus hair and leucotrichia indicated less activity. Severe AA was linked to yellow dots and white patches, whereas less severe cases showed exclamation mark hair and leucotrichia. Novel findings included cotton-wool like patterns and honeycomb pigmentation. The study concludes that trichoscopy effectively reveals subtle diagnostic details not visible to the naked eye.

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research Alopecia Areata: What's New in the Epidemiology, Comorbidities, and Pathogenesis?

49 citations , October 2023 in “Journal of Dermatological Science”

research Alopecia Areata: An Updated Review for 2023

91 citations , May 2023 in “Journal of Cutaneous Medicine and Surgery”

Alopecia Areata affects 2% globally, with treatments like essential oils, garlic, and JAK inhibitors showing promise, but more research is needed.

research Trichoscopy in Alopecia Areata

21 citations , September 2022 in “Actas Dermo-Sifiliográficas”

This study reviews the use of trichoscopy in diagnosing and monitoring alopecia areata, highlighting that certain trichoscopic findings like yellow and black dots, exclamation mark hairs, and others, provide valuable insights into disease status and treatment response.

research Trichoscopy as an Essential Diagnostic Technique for Hair and Scalp Disorders in Skin of Color: A Case-Control Study

July 2021 in “Indian journal of dermatopathology and diagnostic dermatology”

In this study, researchers documented several trichoscopic features that were statistically significant indicators of alopecia and scalp disorders compared to healthy controls.

research Dermoscopic Findings of Alopecia Areata in Dark-Skinned Individuals: An Analysis of 116 Cases

21 citations , January 2014 in “International Journal of Trichology”

This study observed that while dermoscopic features in alopecia areata for dark-skinned individuals align with existing literature, yellow dots appear more frequently and could help in grading disease severity.

research Trichoscopic Findings in Alopecia Areata and Their Relation to Disease Activity, Severity, and Clinical Subtype in Turkish Patients

26 citations , August 2013 in “Australasian Journal of Dermatology”

This study found that certain trichoscopic patterns, like exclamation mark hairs, were associated with active or mild alopecia areata in Turkish patients, aiding in diagnosis and prediction of the disease.

research Trichoscopy in Alopecias: Diagnosis Simplified

96 citations , January 2013 in “International Journal of Trichology”

This article reviews the use of trichoscopy for diagnosing various types of alopecia and reports no new clinical results; it is suggested as a non-invasive method for diagnosis and monitoring treatment responses.

research Utility of Dermoscopy in Alopecia Areata

76 citations , January 2011 in “Indian Journal of Dermatology/Indian journal of dermatology”

In this study, researchers identified yellow dots as the most common dermoscopic feature of alopecia areata, followed by black dots, broken hairs, short vellus hair, and tapering hairs.

research Clinical Significance of Dermoscopy in Alopecia Areata: Analysis of 300 Cases

196 citations , June 2008 in “International Journal of Dermatology”

This study found that dermoscopic indicators like black dots and tapering hairs are valuable markers for diagnosing and assessing the severity and activity of alopecia areata in Asian patients.