Beyond Hairline Recession: Association between Trichoscopic Features and Clinical Severity of Traction Alopecia in Nigerian Women
Ijeoma Christiana Agbara, Nkechi Anne Enechukwu, Thomas Obiora Nnaji, Nnenna Uzunma Okoh, Chibuzor Jonathan Agbara, Jennifer Adaora AlohABSTRACT
Background:
Traction alopecia (TA) is a common cause of hair loss among the women of African descent. While trichoscopy aids the diagnosis, the relationship between trichoscopic features and standardized clinical severity grading remains poorly defined.
Objectives:
To evaluate the association between clinical severity of TA, assessed using the Marginal TA Severity (M-TAS) score, and trichoscopic features among Nigerian female university students.
Materials and Methods:
This descriptive and cross-sectional study was conducted among female students aged ≥18 years with clinically diagnosed TA at Ebonyi State University, Nigeria. Clinical severity was graded using the M-TAS score. Trichoscopy was performed using a DermLite DL4 dermoscope. Associations between trichoscopic features and clinical severity were analyzed using the Chi-square or Fisher’s exact test, with significance at
Results:
Atotal of 177 participants were included, with a mean age of 24.3 ± 3.7 years. Based on M-TAS grading, 44.6% had mild, 45.8% moderate, and 9.6% severe TA. Tubular casts, broken hairs, black dots, yellow dots, and single hair per follicular unit showed a significant association with increasing clinical severity (
Conclusion:
Specific trichoscopic features were associated with increasing clinical severity of TA as graded by M-TAS. The presence of trichoscopic markers of fibrosis across all clinical grades suggests that follicular damage may occur earlier than clinically appreciated. Incorporating trichoscopy into routine assessment may improve the early detection and prevention of irreversible disease.