26 citations,
January 1993 in “Dermatology” Exclamation mark hairs are not exclusive to alopecia areata.
15 citations,
November 2016 in “Journal of The American Academy of Dermatology” Exclamation mark hairs suggest early scalp disease, while white dots indicate it's chronic.
33 citations,
September 2012 in “Australasian Journal of Dermatology” Chemotherapy can cause hair changes similar to alopecia areata, which might lead to misdiagnosis.
January 2021 in “International journal of dermatology, venereology and leprosy sciences” Trichoscopy shows black dots, yellow dots, and empty follicles are common in Alopecia Areata, with broken and exclamation mark hair as typical patterns.
April 2024 in “Journal of cosmetic dermatology” Children with alopecia areata have more exclamation mark hairs and fewer yellow dots than adults.