Development and Validation of the Brigham Eyelash Tool for Alopecia: A Measure of Eyelash Alopecia Areata

The Brigham Eyelash Tool for Alopecia (BELA) was developed and validated to quantify eyelash hair loss in patients with alopecia areata (AA). BELA measures the percentage distribution and grade of eyelashes on the upper lash lines of both eyes. Six dermatologists independently scored 60 randomized images of eyelashes from AA patients, resulting in high intraclass correlation coefficients (ICC) for absolute agreement (0.91 for the right eye, 0.77 for the left eye, and 0.88 overall) and consistency (0.92 for the right eye, 0.78 for the left eye, and 0.89 overall). These results indicated that BELA is a reliable tool for measuring eyelash loss in AA patients. The tool was validated using photographs, and future research will focus on further validation and implementation.