Clinical and trichoscopic graded live visual scale for androgenetic alopecia

Introduction: Currently, the mostly used classifications of androgenetic alopecia (AGA), only provide a macroscopic and subjective description of this disorder, without evaluating trichoscopic features. Objective: The aim of this study is to elaborate a graded live visual AGA severity scale including macroscopic and microscopic (trichoscopic) pictures, and to determine the most frequent trichoscopic characteristics associated to each grade. Methods: A retrospective observational study was conducted on 122 patients (50 females and 72 males) affected by AGA. Macroscopic and trichoscopic photographs were taken at standardized scalp points. Results: Each picture was ranked from AGA stage I to VII, according to Hamilton scale for men and Savin scale for women, and the most representative images of each severity degree were collected to produce a graded live visual scale. In males, two live visual scales, one for the anterior and one for posterior region of the scalp were created. In females, only one scale of the anterior region was realized. For each stage of severity, the corresponding trichoscopic parameters were statistically analyzed. Conclusions: We realized new macroscopic and trichoscopic graded live visual scales for male and female patients affected by AGA, which could help physicians in giving an objective evaluation of the disease and in better managing it.