Perception of baldness and hair density

Dermatology. 2002;204(1):33-6. doi: 10.1159/000051807.


Background: Androgenetic alopecia needs to be scored precisely.

Objective: A possible measure is the ratio between the hair density in the parietal area and that in the occipital area which, being not affected by baldness, supposedly has a 'normal' density.

Methods: On the vertex and just below the occipital protuberance of 109 men, two 1-cm(2) areas were identified. In both areas, hairs were clipped short and photographed by a videomicroscope. Hairs were then counted within a 30-mm(2)-wide central square section.

Results: In the occipital area, the average count was 127/cm(2), without differences among the Hamilton/Norwood classes. In the parietal area, the average density significantly diminished from 138 to 47/cm(2). A main difference was found between classes 1-3 vertex and classes 4-6.

Conclusions: The parietal/occipital ratio decreased significantly only when baldness was clinically manifest. The parietal/occipital ratio cannot be a better measure of baldness severity than the rough Hamilton/Norwood scale. The perception of early baldness does not depend on the diminished hair density, but also on the progressive thinning of the hair shafts.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alopecia / classification*
  • Alopecia / diagnosis
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Self Concept
  • Sensitivity and Specificity
  • Severity of Illness Index