The place of B‐mode ultrasonography, shear‐wave elastography, and superb microvascular imaging in the pre‐diagnosis of androgenetic alopecia

Abstract Purpose Androgenetic alopecia (AGA) is the most common cause of hair loss in males. Physical examination and history are the most important examinations in diagnosis of the disease. As yet, there is no diagnostic method to be able to determine which individuals will develop AGA. Shear‐wave elastography (SWE) is a novel diagnostic tool, which can evaluate tissue stiffness. Superb microvascular imaging (SMI) can determine low flow in microvessels. The aim of the current study was to determine whether or not AGA would develop in individuals with normal hair and a family history of AGA using B‐mode US, SMI, and SWE. Methods The study included 26 patients clinically diagnosed with AGA and a control group of 26 volunteers. Results Thickness with the distance from the epidermis to the calvarium (ECD) on the hairline and cranial subcutaneous tissue thickness (CSTD) were determined to be statistically significantly thinner in the AGA group than in the control group ( p < 0.0001). For the differentiation of the AGA patients, the cutoff value was determined to be 5.5 mm for ECD and 4.05 mm for CSTD. The cranial epidermis‐dermis (CED) stiffness values both as meter/second (m/s) and kilopascals (kPa) were statistically significantly lower in the AGA patients than in the control group ( p < 0.0001). The cutoff values were 6.075 as m/s and 104.4 as kPa. Conclusions The results of this study demonstrated that differentiation could be made of individuals before the development of AGA from normal healthy individuals with CSTD measurement on B‐mode US and CED stiffness measurement on SWE.