P077 Updates on Trichoscopy in Diagnosing Scalp Disorders: A Systematic Review of Diagnostic Accuracy, Sensitivity and Specificity

June 2025 in “ British Journal of Dermatology ”

Sanjay Mehra

trichoscopy alopecia areata androgenetic alopecia telogen effluvium tinea capitis diagnostic accuracy sensitivity specificity NICE guidelines BAD guidelines AI tools national trichoscopy registry hair loss baldness scalp disorders artificial intelligence National Institute for Health and Care Excellence British Association of Dermatologists

TLDR Trichoscopy is highly effective for diagnosing scalp disorders and should be used more in dermatology.

This systematic review highlights the effectiveness of trichoscopy as a diagnostic tool for scalp disorders, analyzing 36 studies with 11,250 patients. Trichoscopy showed high diagnostic accuracy, surpassing traditional methods, with specific sensitivity and specificity metrics for conditions like alopecia areata, androgenetic alopecia, telogen effluvium, and tinea capitis. The review emphasizes the integration of trichoscopy into routine dermatology practice, aligning with NICE and BAD guidelines, and suggests developing standardized criteria, incorporating trichoscopic education, investing in AI tools, and establishing a national trichoscopy registry. These recommendations aim to enhance diagnostic pathways and improve patient care in dermatology.

View this study on academic.oup.com →

Discuss this study in the Community →

Related Community Posts Join

6 / 53 results

community How essential is scalp biopsy when dealing with hair loss?

in Treatment 7 upvotes 8 months ago

The user experienced hair loss despite using Fin and Min for 12 years and switched to Dutasteride, RU58841, and Keto scalp serum, but shedding and itch persist. They are considering increasing Dutasteride to 2.5mg and questioning the necessity of a scalp biopsy, with mixed opinions on its usefulness.

community I bought a microscope, how does my scalp/hairs look? I've been suffering diffuse thinning and hair loss after covid and never recovered (2 yrs ago) I eat healthy, in shape and workout.

in Progress Pictures 87 upvotes 1 year ago

A person with hair loss since COVID-19 is considering treatments like finasteride and minoxidil but is hesitant due to potential side effects. Suggestions include visiting a dermatologist, using a ketoconazole shampoo, and considering that post-COVID hair loss might be an autoimmune response.

community If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

in Research 830 upvotes 10 months ago

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

community Study: There is 70x Higher Unconjugated DHT in Feces Compared To Blood Levels in Young Adults - Gut Microbiota Manages DHT Recycling and Metabolism

in Research/Science 194 upvotes 2 weeks ago

Gut microbiota significantly influences androgen metabolism, impacting hair loss treatments like finasteride. Probiotics, dietary changes, and fecal microbiota transplants may help manage DHT levels and improve hair health.

community 2.5 years Minoxidil and HRT, CPA->Lupron +Minox 5%

in Transgender 611 upvotes 7 months ago

The user experienced significant hair regrowth after 2.5 years of using Minoxidil 5% and hormone replacement therapy (HRT) with Lupron, despite initial scalp irritation. Finasteride was ineffective for them.

community My experience and a discourse on “DUPA”

in Chat 46 upvotes 2 years ago

How diffuse unpatterned alopecia (DUPA) is not an invitation to self-diagnose oneself with aggressive AGA and that seeking a specialized dermatologist may help people experiencing hair loss. Treatment options discussed include topical clobetasol propionate, oral minoxidil, and discontinuing finasteride.

Related Research

1 / 1 results

Quantitative Analysis of the Anatomical Changes in the Scalp and Hair Follicles in Androgenetic Alopecia Using Magnetic Resonance Imaging

research Quantitative Analysis of the Anatomical Changes in the Scalp and Hair Follicles in Androgenetic Alopecia Using Magnetic Resonance Imaging

2 citations, June 2020 in “Skin Research and Technology”

MRI reveals thinner scalps and smaller hair follicles in people with androgenetic alopecia.