A Segmental Approach to Scoring Hair Density from Global Images: Introducing the Scalp Coverage Scoring Method for Clinical Trials and Practice

June 2024 in “ Nature Cell and Science ”

D. Van Neste, D. Hugh Rushton, Gillian E. Westgate, L. Duteil, Koen Roegies, V. Ronsse

Scalp Coverage Scoring hair density thinning hair hair productivity measurements artificial intelligence deep learning quantify hair loss hair regrowth SCS AI

Studysummary In this research, experienced clinicians noted inconsistency in the reproducibility of the commonly used Hamilton-Ludwig scales for assessing pattern hair loss severity in photographic assessments, leading to the proposal of a new 5-point scale for staging female hair loss.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The study introduces the Scalp Coverage Scoring (SCS) method as a reliable and calibrated approach for assessing hair density from global images, aimed at improving clinical trials and practice. Tested on 10 patients with thinning hair and involving 880 field examinations by a principal investigator and 14 trained observers, the method showed a high correlation (r = 0.975) between the scores of the principal investigator and the trained observers. The SCS method, combined with hair productivity measurements, offers a promising tool for future research in artificial intelligence and deep learning, providing a standardized and objective way to quantify hair loss and regrowth.

View this study on cellnatsci.com →

Discuss this study in the Community →

Research cited in this study

26 / 26 results

Response to the Article 'Evaluation of Standardized Scalp Photography on Patient Perception of Hair Loss Severity, Anxiety, and Treatment'

research Response to the Article 'Evaluation of Standardized Scalp Photography on Patient Perception of Hair Loss Severity, Anxiety, and Treatment'

1 citations , June 2022 in “Journal of The American Academy of Dermatology”

Combining scalp photos with hair density and caliber measurements gives a more accurate assessment of hair loss.

research Pharmacological Management of Pattern Hair Loss

2 citations , October 2021 in “Indian Journal of Plastic Surgery”

This review discusses pharmacological treatments for pattern hair loss, focusing on minoxidil and finasteride's safety and efficacy, and reports no new clinical results.

research Evaluation of Standardized Scalp Photography on Patient Perception of Hair Loss Severity, Anxiety, and Treatment

6 citations , January 2021 in “Journal of The American Academy of Dermatology”

Scalp photography helps patients feel less anxious about hair loss, agree more with doctors on severity, and stay motivated for treatment.

Exhaustive Analysis of Scalp Hair Regression: Subjective and Objective Perception from Initial Hair Loss to Severe Miniaturization and Drug-Induced Regrowth

research Exhaustive Analysis of Scalp Hair Regression: Subjective and Objective Perception from Initial Hair Loss to Severe Miniaturization and Drug-Induced Regrowth

3 citations , January 2021 in “Plastic and Aesthetic Research”

This study found that hair mass index can effectively link hair productivity with clinical scalp coverage perception, suggesting its potential usefulness in diagnosing hair loss patterns and responses to treatment.

Placebo-Controlled Dose-Effect Studies with Topical Minoxidil 2% or 5% in Male-Patterned Hair Loss Treated with Oral Finasteride Employing an Analytical and Exhaustive Study Protocol

research Placebo-Controlled Dose-Effect Studies with Topical Minoxidil 2% or 5% in Male-Patterned Hair Loss Treated with Oral Finasteride Employing an Analytical and Exhaustive Study Protocol

5 citations , January 2020 in “Skin Research and Technology”

This study reported that combined oral finasteride and topical 5% minoxidil treatment in men with male-pattern hair loss improved hair growth by initiating anagen in pre-existing but deficient follicles, yet the growth rates remained unchanged and did not normalize hair productivity.

research Viable Terminal Scalp Hair Follicles Are Necessary and Sufficient for Clinical Efficacy of Finasteride in Male Pattern Hair Loss

6 citations , June 2019 in “Skin Research and Technology”

In this study, finasteride treatment for two years did not significantly reverse miniaturized hair follicles in men with male pattern hair loss, challenging the "reversal hypothesis" as 79 out of 113 miniaturized hairs remained unchanged.

Maintenance of Optimized Hair Growth from Viable Terminal Scalp Hair Follicles at Baseline with Oral Finasteride in Male Pattern Hair Loss and First Evidence of a Drug Dependency and a Post-Finasteride Rebound Effect

research Maintenance of Optimized Hair Growth from Viable Terminal Scalp Hair Follicles at Baseline with Oral Finasteride in Male Pattern Hair Loss and First Evidence of a Drug Dependency and a Post-Finasteride Rebound Effect

4 citations , May 2019 in “Skin Research and Technology”

This study found that male pattern hair loss worsened significantly after stopping finasteride, revealing a "rebound effect" where terminal hair transformed into miniaturized hair over 30 months off the drug.

research The Trichoscopy Derived Sinclair Scale: Enhancing Visual Assessment Through Quantitative Trichoscopy

6 citations , December 2018 in “Australasian Journal of Dermatology”

This study found a strong correlation between the Sinclair Scale and cumulative hair thickness density, allowing the estimation of the Sinclair Scale from trichoscopy-derived statistics.

research Comparative Evaluation Between Two Nutritional Supplements in the Improvement of Telogen Effluvium

9 citations , September 2018 in “Clinical, Cosmetic and Investigational Dermatology”

This study found that, in female patients with idiopathic telogen effluvium, a supplement containing zinc, biotin, and other nutrients significantly improved hair loss and quality over 180 days, whereas another supplement with different ingredients had less consistent effects.

research Evidence-Based Guideline for the Treatment of Androgenetic Alopecia in Women and Men – Short Version

145 citations , November 2017 in “Journal of The European Academy of Dermatology and Venereology”

This guideline review by the European Dermatology Forum evaluates current treatments for androgenetic alopecia but reports no new research findings, aiming to assist dermatologists in selecting safe and effective therapies.

research Hair Regrowth in Male and Female Pattern Hair Loss Does Not Involve the Conversion of Vellus Hair to Terminal Hair

14 citations , January 2016 in “Experimental Dermatology”

This analysis concluded that hair regrowth in male and female pattern hair loss treatments did not involve converting vellus hairs into terminal hairs, suggesting a reactivation of dormant non-vellus follicles instead.

research Quantitative Assessment of Female Pattern Hair Loss

5 citations , February 2015 in “Dermatologica Sinica”

In this study, a computer-aided imaging system accurately measured the width of balding areas in female pattern hair loss, correlating strongly with clinical staging severity.

research Progression of Hair Loss in Men With Androgenetic Alopecia: Long-Term Controlled Observational Data in Placebo-Treated Patients

9 citations , December 2008

In this study, untreated men with androgenetic alopecia continued to experience progressive hair loss over a 5-year period, with a significant decline in hair density observed in the placebo group.

research Validation of Scalp Coverage Scoring Methods for Scalp Hair Loss in Male Pattern Hair Loss (Androgenetic Alopecia)

5 citations , April 2006 in “Skin Research and Technology”

This study found that US and EU experts provided similar ratings of hair loss changes from global photographs in male subjects with androgenetic alopecia, supporting the use of standardized photographic evaluations.

research Natural Scalp Hair Regression in Preclinical Stages of Male Androgenetic Alopecia and Its Reversal by Finasteride

24 citations , January 2006 in “Skin Pharmacology and Physiology”

This study found that finasteride (1 mg/day) appeared to reverse the shortening of the hair cycle in androgen sensitive sites but did not convert miniaturized hair into terminal hair.

research Prevalence of Male and Female Pattern Hair Loss in Maryborough

193 citations , August 2005 in “Journal of Investigative Dermatology Symposium Proceedings”

This study found that the prevalence of androgenetic alopecia increases with age among both men and women in Maryborough, Australia, with 57% of women and 73.5% of men aged 80 and over affected.

research Validation and Clinical Relevance of a Novel Scalp Coverage Scoring Method

14 citations , January 2003 in “Skin Research and Technology”

This study found that the scalp coverage scoring (SCS) method is a non-invasive and reproducible technique that effectively measures hair growth and loss dynamics in male subjects with androgenetic alopecia.

research Perception of Baldness and Hair Density

16 citations , January 2002 in “Dermatology”

This study found that the parietal/occipital hair density ratio decreases significantly only when baldness is visibly present, making it no better than the Hamilton/Norwood scale for assessing baldness severity.

research The Prevalence and Types of Androgenetic Alopecia in Korean Men and Women

157 citations , July 2001 in “British Journal of Dermatology”

In this study, the prevalence of androgenetic alopecia among Korean men and women was found to be lower than in caucasians, with Korean men showing more frontal hairline preservation and a higher incidence of 'female pattern' hair thinning.

research Finasteride Increases Anagen Hair in Men with Androgenetic Alopecia

129 citations , October 2000 in “British Journal of Dermatology”

This study found that finasteride increases anagen hair growth in men with androgenetic alopecia.

research Finasteride in the Treatment of Men with Androgenetic Alopecia

581 citations , October 1998 in “Journal of The American Academy of Dermatology”

In male pattern hair loss, this study found that finasteride 1 mg daily significantly slowed hair loss and increased hair growth over two years compared to placebo.

research Natural Progression of Male Pattern Baldness in Young Men

71 citations , May 1991 in “Clinical and Experimental Dermatology”

Young men with male pattern baldness lose hair density over time without treatment.

research Androgenetic Alopecia: Clinical Aspects and Treatment

19 citations , January 1990 in “Springer eBooks”

research Quantitative Assessment of 2% Topical Minoxidil in the Treatment of Male Pattern Baldness

31 citations , January 1989 in “Clinical and Experimental Dermatology”

In this study, topical 2% minoxidil did not significantly improve hair density measures in men with male pattern baldness, although there was no deterioration, suggesting a potential prophylactic effect.

research Patterned Androgenic Alopecia in Women

130 citations , May 1988 in “Journal of The American Academy of Dermatology”

This study found that frontal and frontoparietal hair recession is relatively common in women, especially after menopause, and may not indicate abnormal androgen metabolism absent other virilization signs.

research Classification of the Types of Androgenetic Alopecia (Common Baldness) Occurring in the Female Sex

666 citations , September 1977 in “British Journal of Dermatology”

This article presents a classification system for stages of female-pattern androgenetic alopecia to aid early diagnosis and mentions existing systems for rare male-pattern cases, but reports no new clinical results.