Scalp Photodamage in Balding Men: An Observational Study Combining a Novel Clinical Scoring Method with Estimation of Individual Sun Exposure History and Risk Factors

The observational study aimed to assess scalp photodamage in balding men and identify risk factors associated with actinic damage. A total of 144 men with androgenetic alopecia (AGA), aged between 30 and over 71, were enrolled across four European centers. A novel clinical scoring method was used to evaluate the severity of scalp photodamage, which was then correlated with individual lifetime sun exposure history. The study found that lesions were more frequent in the oldest age group, with lentigines, brown uniform hyperpigmentation, stellate scars, and scalp atrophy being common. Actinic keratoses were most frequent in the older group, while squamous cell and basal cell carcinomas were scarce, and no melanoma was found. Pruritus was the most commonly reported subjective sensation. Risk factors for scalp photodamage appeared to be related to geographical location, history of sunburn, and age. The study concluded that the novel global scale developed could be used as a rapid method for assessing scalp photodamage severity, with good agreement between the scale and clinical scores.