A dermatologist may consider several criteria when determining the severity of their patient’s hair loss. Since 2004, some doctors have used the Severity of Alopecia Tool (SALT) to describe the extent of scalp hair loss in the disease. Researchers developed the scale to have a common tool for measuring hair regrowth with treatment. The SALT score describes the percentage of scalp hair loss and ranges from 0 to 100. A SALT score of 100 means complete (or 100%) scalp hair loss. A SALT score of 0 means there is no scalp hair loss. A SALT score of 50 or greater is generally considered severe disease. SALT is a useful tool. However, the SALT score only looks at scalp hair loss when determining alopecia areata severity, not body hair. Nor does it take into account the eyebrows and eyelashes. It also ignores the emotional and mental effects of living with the disease. Alopecia Areata Severity Scale In 2022, researchers published the Alopecia Areata Scale (AASc). They felt it more accurately captured hair loss severity. First, they looked for mild, moderate, or severe scalp hair loss. The researchers then considered other factors, such as body hair loss and the disease’s psychological impact. Has the hair loss negatively impacted the patient’s psychosocial functioning? For example, does the hair loss prevent the patient from going out? Is the patient depressed because of it? Is there noticeable hair loss from the eyebrows or eyelashes? Has the patient had treatment for at least six months without positive effect? Is the hair pull test positive? If a patient has any of the above factors, the severity level (based on percentage of scalp hair loss) increases a level. So, for example, if a patient has 30% scalp hair loss and also has eyebrow loss, they would be considered “severe” according to the AASc scale. The Alopecia Areata Scale considers more than just scalp hair loss. It will help dermatologists accurately describe each patient’s disease severity, which will aid in choosing the right treatment. Learn what to expect when you visit your dermatologist on the Symptoms and Diagnosis page.
