What women want - quantifying the perception of hair amount: an analysis of hair diameter and density changes with age in caucasian women

Summary Background It has long been known that women lose satisfaction with their hair with ageing. Our data show that caucasian women perceive a decrease in hair amount in their mid 40s with a further decrease in the mid to late 50s, which leads to this dissatisfaction. Neither loss of density (hairs per cm2) nor shaft diameter alone can fully account for this perception. A new metric, ‘hair amount’, is proposed as a quantitative metric combining the impact of both density and diameter on the perception of hair loss. Objectives Creation of a single parameter combining the contribution of diameter and density to perception of female age-related hair loss. Methods In total, 1099 caucasian women (ages 18–66 years) with self-perceived hair loss and 315 caucasian women (ages 17–86 years) with no complaint of hair loss were evaluated. Scalp hair diameter was measured using optical fibre diameter and image analysis. Scalp hair density was measured by phototrichogram with manual or automated counting. Results Parietal scalp hair diameter increased from ages 20 to 40–45 years, then decreased. Hair density was highest in the youngest group, age 20–30 years, and decreased thereafter with increasing rate. In women self-perceiving hair loss, the rate of decrease in density was significantly faster than for women with no self-perception of hair loss. The combined metric ‘hair amount’ was relatively constant at younger ages, increasing very slightly to age 35 years, then decreasing significantly. Conclusions Increasing hair shaft diameter offsets decreasing hair density through the mid 30s. After that, a lower rate of diameter increase combined with the decrease in density begins to significantly impact the perception of hair amount so that thinning becomes increasingly more noticeable in the mid 40s to the mid to late 50s. Quantitative determination of hair amount is a useful tool to combine the contributions of hair density and diameter to women’s perception of age-related hair loss.