Trichoscopy of Androgenetic Alopecia: A Systematic Review

March 2024 in “ Journal of clinical medicine ”

Agata Kuczara, Anna Waśkiel‐Burnat, Adriana Rakowska, Małgorzata Olszewska, Lidia Rudnicka

androgenetic alopecia hair diameter variability vellus hairs peripilar sign perifollicular inflammation yellow dots trichoscopy AGA

Studysummary This study examined trichoscopic findings in androgenetic alopecia, reporting that hair diameter variability, vellus hairs, and the peripilar sign are valuable indicators for diagnosing this condition. Our plain-language summary of this paper — not a Tressless recommendation.

The systematic review "Trichoscopy of Androgenetic Alopecia" analyzed 34 articles and included 2860 patients with androgenetic alopecia (AGA). The study found that the most common trichoscopic features in AGA patients were hair diameter variability (94.07%), vellus hairs (66.45%), and the peripilar sign (43.27%). Hair diameter variability was observed in all stages of male AGA and in women, it correlated with the severity of the disease. The peripilar sign, a brown halo indicating perifollicular inflammation, had the highest specificity and a significant positive predictive value. The presence of at least four yellow dots in the frontal area of the scalp on trichoscopic examination is a major criterion to identify female AGA. The study concluded that hair diameter variability, vellus hairs, and the peripilar sign are valuable indicators for the diagnosis of AGA.

View this study on mdpi.com →

Discuss this study in the Community →

Research cited in this study

48 / 48 results

research Trichoscopy – A Valuable Tool for Identifying Conditions Mimicking Androgenetic Alopecia

November 2023 in “International Journal of Dermatology”

This review presents European expert guidelines for diagnosing androgenetic alopecia across genders but reports no new clinical findings; it emphasizes the importance of trichoscopy for differentiating similar conditions.

research A Clinico-Trichological Study of Female Androgenetic Alopecia

November 2021 in “International Journal of Trichology”

This study found that trichoscopy can confirm the diagnosis and assess the clinical severity of female androgenetic alopecia, correlating specific features with different severity grades.

research Trichoscopic Findings in Androgenetic Alopecia

3 citations , January 2021 in “Medicinski arhiv”

In this study, trichoscopic examination revealed that patients with androgenetic alopecia had significantly more yellow dots, pilosebaceous units with one hair, and increased perifollicular hyperpigmentation compared to healthy controls.

research Androgenetic Alopecia in Women and Men: Italian Guidelines Adapted from European Dermatology Forum/European Academy of Dermatology and Venereology Guidelines

4 citations , December 2020 in “Giornale italiano di dermatologia e venereologia”

This guideline summarizes evidence-based and expert-based recommendations for treating androgenetic alopecia, adapted by an Italian expert group in alignment with Italian pharmacological policies.

research Trichoscopic Evaluation of Frontal Hairline Recession in Egyptian Female Patients

4 citations , February 2020 in “Journal of Cosmetic Dermatology”

This study found that androgenetic alopecia was the most common cause of frontal hairline recession in Egyptian female patients, supporting the use of trichoscopy as a noninvasive diagnostic tool.

research Fibrosing Alopecia in a Pattern Distribution

30 citations , January 2020 in “Journal of The American Academy of Dermatology”

This review reports no new clinical results but discusses fibrosing alopecia in a pattern distribution as a distinct scarring alopecia with characteristics of both androgenetic alopecia and lichen planopilaris.

research Frontal Fibrosing Alopecia: A Disease That Remains Enigmatic

9 citations , January 2020 in “Postepy Dermatologii I Alergologii”

This review discusses the enigmatic nature of frontal fibrosing alopecia and reports no clinical results; the authors stress the need for further research.

research Trichoscopic Patterns of Nonscarring Alopecia

8 citations , January 2020 in “International Journal of Trichology”

The authors concluded that trichoscopy is a valuable noninvasive tool for diagnosing and monitoring nonscarring alopecia, aiding in the identification of new hair signs in difficult cases.

research Female Androgenetic Alopecia: An Update on Diagnosis and Management

43 citations , November 2019 in “American Journal of Clinical Dermatology”

This review discusses female androgenetic alopecia, highlighting its diagnostic challenges and management strategies, but it reports no new results.

research Physiopathology and Current Treatments of Androgenetic Alopecia: Going Beyond Androgens and Anti-Androgens

45 citations , August 2019 in “Dermatologic Therapy”

This review discusses the physiopathology of androgenetic alopecia and evaluates various traditional and emerging treatments, reporting no new clinical results but highlighting the need for enhanced treatment strategies.

research Preliminary Results of the Use of Scalp Microneedling in Different Types of Alopecia

24 citations , June 2019 in “Journal of Cosmetic Dermatology”

This study found that microneedling improved hair density and thickness with minimal side effects in patients with androgenetic alopecia and telogen effluvium.

research Utility of Trichoscopy to Diagnose Early Female Pattern Hair Loss in Resource-Poor Setting: A Cross-Sectional Study

6 citations , January 2019 in “Indian Journal of Dermatology, Venereology and Leprology”

In this study, researchers found that a low-cost USB dermoscope can effectively detect microscopic hair changes associated with early female pattern hair loss, making it a useful tool for diagnosis even without expensive equipment or programs.

research The Efficacy of Topical Minoxidil 2% Versus Topical Botanically Derived Inhibitors of 5 Alpha Reductase in Treatment of Female Pattern Hair Loss by Trichoscopy

1 citations , January 2019 in “Journal of the Egyptian Women's Dermatologic Society (Print)”

This study observed that while both minoxidil and botanically-derived 5-alpha reductase inhibitors significantly increased hair count and diameter in women with female pattern hair loss, minoxidil was more effective, especially for greater hair diameter increases, but had more troublesome side effects.

research Correlation of Trichoscopic Findings in Androgenetic Alopecia and the Disease Severity

12 citations , January 2019 in “International Journal of Trichology”

This study found that trichoscopy revealed significant differences in certain variables, such as the brown peripilar sign and white peripilar sign, which may aid in diagnosing early and late stages of androgenetic alopecia.

research Dermoscopic Pre- And Post-Treatment Evaluation In Patients With Androgenetic Alopecia On Platelet-Rich Plasma—A Prospective Study

5 citations , December 2018 in “Journal of Cosmetic Dermatology”

This study found that after treatment with platelet-rich plasma, male androgenetic alopecia patients showed significant improvements in hair count, hair diversity, and reduction in certain dermoscopic features.

research White And Yellow Dots As New Trichoscopic Signs Of Severe Female Androgenetic Alopecia In Dark Skin Phototypes

9 citations , July 2018 in “International Journal of Dermatology”

This study suggests that yellow and white dot signs may be new dermoscopic indicators of advanced androgenetic alopecia in dark-skinned females, with certain trichoscopic features associated with darker skin types.

research Platelet-Rich Plasma on Female Androgenetic Alopecia: Tested on 10 Patients

25 citations , April 2018 in “Journal of Cosmetic Dermatology”

This study found that platelet-rich plasma injections improved hair density and diameter in women with androgenetic alopecia not responding to other treatments over 24 weeks, with no adverse events reported.

research Study of the Efficacy of Carboxytherapy in Alopecia

16 citations , February 2018 in “Journal of Cosmetic Dermatology”

This study observed that carboxytherapy significantly improved clinical and dermoscopic measures in patients with alopecia areata and androgenetic alopecia compared to placebo, though some benefits regressed during follow-up.

research Genetic and Molecular Aspects of Androgenetic Alopecia

24 citations , January 2018 in “Indian Journal of Dermatology, Venereology and Leprology”

This review discusses advances in molecular biology and genetics related to androgenetic alopecia and reports no new clinical results.

research Utility of Horizontal Sections of Scalp Biopsies in Differentiating Between Androgenetic Alopecia and Alopecia Areata

3 citations , January 2018 in “Dermatology”

This study found that transverse sections of scalp biopsies, particularly looking at the anagen:non-anagen hair ratio and presence of pigment casts, effectively distinguish alopecia areata from androgenetic alopecia.

research Yellow Dots in Trichoscopy: Relevance, Clinical Significance, and Peculiarities

13 citations , October 2017 in “Anais Brasileiros de Dermatologia”

This review highlights the occurrence of yellow dots, a trichoscopic finding, in several scalp conditions beyond alopecia areata and reports no new clinical results.

Two Different Trichoscopic Patterns of Mid-Frontal Scalp in Patients with Frontal Fibrosing Alopecia and Clinical Features of Androgenetic Alopecia

research Two Different Trichoscopic Patterns of Mid-Frontal Scalp in Patients with Frontal Fibrosing Alopecia and Clinical Features of Androgenetic Alopecia

2 citations , January 2017 in “Przegla̧d dermatologiczny”

This study identified two distinct trichoscopic patterns in the mid-frontal scalp of patients with frontal fibrosing alopecia who also display clinical features of androgenetic alopecia.

research Stem Cell Therapy as a Novel Therapeutic Intervention for Resistant Cases of Alopecia Areata and Androgenetic Alopecia

39 citations , August 2016 in “Journal of Dermatological Treatment”

This study observed that autologous bone marrow derived mononuclear cells and follicular stem cells were both safe and effective for improving resistant alopecia areata and androgenetic alopecia, with no serious adverse events.

research Relevance of Trichoscopy in the Differential Diagnosis of Alopecia: A Cross-Sectional Study from North India

38 citations , January 2016 in “Indian Journal of Dermatology, Venereology and Leprology”

This study found that trichoscopy was useful in diagnosing different types of alopecia, with specific trichoscopic features aiding in the differential diagnosis.

research Classifications of Patterned Hair Loss: A Review

101 citations , January 2016 in “Journal of Cutaneous and Aesthetic Surgery”

This review discusses various classification systems for patterned hair loss in both sexes and reports no new clinical findings, highlighting the Hamilton-Norwood and Ludwig systems as the most commonly used.

research Trichoscopic Findings of Androgenetic Alopecia and Their Association with Disease Severity

30 citations , March 2015 in “Journal of Dermatology”

This study found that certain trichoscopic features like white peripilar sign, yellow dots, and scalp pigmentation are positively correlated with the severity of androgenetic alopecia in Chinese patients.

research Trichoscopic Findings of Hair Loss in Koreans

16 citations , January 2015 in “Annals of Dermatology”

In this study, trichoscopic features aiding differential diagnosis of alopecia in Korean patients were found to be similar to those in Caucasians, but pigment pattern frequencies differed due to racial characteristics.

research Lichen Planopilaris in the Androgenetic Alopecia Area: A Pitfall for Hair Transplantation

14 citations , January 2015 in “Skin appendage disorders”

This study reports that subtle presentations of lichen planopilaris may be mistaken for seborrheic dermatitis in patients with androgenetic alopecia, highlighting the importance of dermatoscopy-guided biopsy for accurate diagnosis.

A Nonrandomized Study of Trichoscopy Patterns Using Nonpolarized (Contact) and Polarized (Noncontact) Dermatoscopy in Hair and Shaft Disorders

research A Nonrandomized Study of Trichoscopy Patterns Using Nonpolarized (Contact) and Polarized (Noncontact) Dermatoscopy in Hair and Shaft Disorders

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

This study reported that polarized dermoscopy was better for visualizing vascular patterns, scaling, and reticular pigmentation, while nonpolarized mode better documented features like black dots and tapered hair in various hair and scalp conditions.

research Scalp Dermatoscopic Findings in Androgenetic Alopecia and Their Relations with Disease Severity

30 citations , January 2014 in “Annals of Dermatology”

This study observed no significant relationship between trichoscopic findings and disease severity in male or female androgenetic alopecia, despite some specific patterns correlating with different severity levels in female patients.

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 Vellus Hairs in the Frontal Scalp in Early Female Pattern Hair Loss

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

This study suggests that the presence of more than six vellus hairs in the frontal scalp at 20-fold magnification can be an additional criterion for diagnosing early female pattern hair loss.

research Is Trichoscopy a Reliable Tool to Diagnose Early Female Pattern Hair Loss?

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

This study found that trichoscopy using anisotrichosis criteria was 75% sensitive and 61.54% specific in diagnosing early female pattern hair loss in women without visible hair thinning.

research Dermoscopy Findings in Female Androgenetic Alopecia

12 citations , October 2012 in “Anais Brasileiros De Dermatologia”

This study found that dermoscopy is an effective tool for diagnosing and monitoring androgenetic alopecia in women, as it helped identify common signs such as hair miniaturization and peripilar brown halo.

research Black Dots Seen Under Trichoscopy Are Not Specific for Alopecia Areata

42 citations , June 2012 in “Clinical and Experimental Dermatology”

This study found that 'black dots' seen under trichoscopy are not specific to alopecia areata and may occur in various other hair and scalp conditions.

research Hair and Scalp Dermatoscopy

245 citations , March 2012 in “Journal of The American Academy of Dermatology”

This review discusses the dermoscopic features of common hair and scalp disorders and reports no new clinical results, aiming to assist dermatologists in diagnosing conditions like tinea capitis and alopecia areata.

research Female Pattern Hair Loss: Clinical and Laboratory Findings and Trichoscopy Depending on Disease Severity

28 citations , January 2012 in “International Journal of Trichology”

This study observed that specific trichoscopic features like white peripilar signs, scalp pigmentation, and focal atrichia are associated with advanced female pattern hair loss in Fitzpatrick skin type III patients.

research Value of Trichoscopy Versus Trichogram for Diagnosis of Female Androgenetic Alopecia

45 citations , January 2012 in “International Journal of Trichology”

This study reported that trichoscopy is a more effective diagnostic tool than the trichogram for early diagnosis of FAGA, regardless of hair shaft diversity cut-off levels.

research Trichoscopy Update 2011

178 citations , December 2011 in “Journal of Dermatological Case Reports”

This review discusses the application of trichoscopy in diagnosing various hair and scalp diseases and reports no new clinical results; the authors emphasize its role as a non-invasive diagnostic tool.

research Clinical Evaluation of Alopecias Using a Handheld Dermatoscope

66 citations , November 2011 in “Journal of The American Academy of Dermatology”

This study concluded that a polarized-light handheld dermatoscope attached to a digital camera is a practical and useful tool for diagnosing different types of alopecia.

research Pinpoint White Dots in the Scalp: Dermoscopic and Histopathologic Correlation

60 citations , September 2010 in “Journal of the American Academy of Dermatology”

Small white dots on the scalp seen with a dermoscope correspond to sweat ducts and vary with different hair disorders.

research Trichoscopy in the Healthy Female: Method Standardization and Norms for Measurable Parameters

46 citations , April 2009 in “Journal of Dermatological Case Reports”

This study established standard trichoscopy norms for adult white females, providing benchmarks for hair thickness, percentage of thin hairs, and pilosebaceous units with single hair across different scalp areas.

research Scalp Dermoscopy of Androgenetic Alopecia in Asian People

67 citations , February 2009 in “Journal of Dermatology”

This study found that dermoscopy can be a useful tool for diagnosing androgenetic alopecia, particularly in determining hair diameter diversity as an essential feature in Asian populations.

research Dermoscopy in Female Androgenic Alopecia: Method Standardization and Diagnostic Criteria

129 citations , January 2009 in “International Journal of Trichology”

This study found that trichoscopy criteria can distinguish female androgenic alopecia from chronic telogen effluvium, with specific features achieving 98% diagnostic specificity.

research Presence and Future of Dermoscopy

11 citations , December 2006 in “Expert Review of Dermatology”

This article examines the emerging role of dermoscopy in skin cancer diagnosis and reports no new clinical findings; the authors highlight its potential to enhance dermatological practice.

research Videodermoscopy in the Evaluation of Hair and Scalp Disorders

304 citations , July 2006 in “Journal of The American Academy of Dermatology”

This study found that videodermoscopy enhances diagnostic accuracy for scalp and hair disorders beyond simple clinical inspection and reveals novel disease features that could improve clinical understanding.

research Histological Features of Peripilar Signs Associated with Androgenetic Alopecia

95 citations , January 2004 in “Archives of Dermatological Research”

This study found that peripilar signs on the scalp are linked to perifollicular lymphocytic infiltrates in early androgenetic alopecia, detectable even in areas with high hair density.

research Molecular Mechanisms of Androgenetic Alopecia

229 citations , August 2002 in “Experimental Gerontology”

This paper discusses key mechanisms of androgen metabolism in androgenetic alopecia and reports the effectiveness of treatments like oral finasteride and topical minoxidil, highlighting the limited success rate due to factors like follicular inflammation.