Trichoscopic Analysis of Androgenetic Alopecia in Men Less than Forty Years of Age: A Retrospective, Observational Study from a Tertiary Care Hospital
Published: April 1, 2026 | DOI: https://doi.org/10.7860/JCDR/2026/76672.22773
S Asiya Begum, Rahul Krishna Kota, Sowmya Harshitha Padmanabhuni
1. Assistant Professor, Department of Dermatology, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India.
2. Faculty, Department of Dermatology, GSL Medical College, Rajahmundry, Andhra Pradesh, India.
3. Consultant Dermatologist, Department of Dermatology, Kesavam Dermacare, Guntur, Andhra Pradesh, India.
Correspondence
Dr. S Asiya Begum,
G2, Mahogany, Amrutha Valley, Banjara Hills Road 12, Hyderabad-500034, Telangana, India.
Email: dr.asiya21@gmail.com
Introduction: Androgenetic Alopecia (AGA) is the most common cause of hair loss worldwide. It is a non-scarring, progressive, patterned, and androgen-dependent condition seen in genetically predisposed individuals. AGA presents as gradual loss of terminal scalp hair. Trichoscopy is non-invasive dermoscopic imaging of the scalp and hair. It helps assess the disease activity, severity, and prognosis in trichology.
Aim: To identify and evaluate the association of trichoscopic features with severity of AGA in men under forty years of age.
Materials and Methods: The present retrospective, observational study was conducted in the Dermatology Department at Medical College and Research Institute, Bengaluru, Karnataka, India. The duration of the study was 12 months between January 2019 to December, 2019. Fifty men under the age of 40 with AGA were enrolled. Diagnosis was made based on clinical examination of all the areas of the scalp. Age, history, clinical type, and duration of disease were noted. Trichoscopic evaluation of the scalp was done and relevant images were captured. A digital trichoscope (Firefly DE330T videodermatoscope USA) was used. AGA grades 1 & 2 were categorised as mild; grades 3 & 4 as moderate, and grade 5 & 6 as severe. Chi Square test was used for statistical analysis. The results were considered statistically significant if the p<0.05.
Results: Among the 50 subjects, the youngest was 17 years and the oldest was 40 years. Seven trichoscopic features were observed, which were anisotrichosis, peripilar sign, white dots, yellow dots, predominance of single-hair follicular units, focal atrichia, and scalp pigmentation. All cases (100%) exhibited anisotrichosis, irrespective of AGA severity, making it the most common feature. Significant associations were found between AGA grading and the presence of white dots (p=0.035), focal atrichia (p=0.0007), and honeycomb pigmentation (p=0.0024).
Conclusion: The study found an association between white dots, focal atrichia and honeycomb pigmentation of the scalp and the grade of AGA. Trichoscopy detects early changes in hair follicles, often preceding visible and irreversible baldness. It is an excellent non-invasive tool that allows for the rapid scanning of large areas.
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