Vertex Accentuation in Female Pattern Hair Loss

Background: The most common cause of hair loss seen in women is female pattern hair loss (FPHL), also known as female androgenetic alopecia. It affects the central part of the scalp, but spares the frontal hairline. Frontal accentuation was also described by Olsen. In Asian women, vertex thinning patterns are frequently developed, but there has been no report about vertex thinning pattern in female pattern hair loss. Objective: To find prevalence of vertex accentuation in female pattern hair loss (FPHL) in Asian women. Methods: Scalp hair counting (n/cm 2 ) were measured at 3 different areas; vertex, mid scalp and frontal area respectively by digital dermoscope (Dino digital AM-413T). Visual counting and photography were performed. Outcomes were evaluated by gross appearance of vertex thinning and/or hair density <120 /cm 2 in any of 3 areas. Results: 143 patients were evaluated. Mean age was 45.54 years. Of the hair loss type, 36.4% were mid-scalp, 33.6% were vertex accentuation and 30.1% were frontal accentuation, respectively. Age was not significantly different among the 3 types of hair loss (P- value 0.859). Conclusion: Although the most common female pattern hair loss type is diffuse type (Ludwig type), vertex accentuation pattern is the second most common pattern in this study. This study is the first to mention “Vertex accentuation” to be another pattern for FPHL.