Assessment tools offer ways to evaluate AA severity1,2

There are many methods to assess AA disease severity. Below is an overview of two assessment tools:

Severity of Alopecia Tool (SALT) is focused on scalp hair loss and is commonly used in clinical trials2-4

Alopecia Areata (AA) Scale is a recently developed tool designed for use in clinical practice1

There are many methods to assess AA disease severity. Below is an overview of two assessment tools:

Severity of Alopecia Tool (SALT) is focused on scalp hair loss and is commonly used in clinical trials2-4

Alopecia Areata (AA) Scale is a recently developed tool designed for use in clinical practice1

The Severity of Alopecia Tool (SALT)

SALT score is used in clinical trials to assess the extent of scalp hair loss.2-4 *

SALT
Score

Percentages are quadrant surface area.

The SALT score is calculated by1:

  • Multiplying the percentage of hair loss in each of the 4 quadrants of the scalp by the quadrant surface area
  • Adding the 4 values together for a composite score

Maximum SALT score of 100 indicates complete scalp hair loss

Minimum SALT score of 0 indicates no hair loss

*Used with permission.
†Reprinted from J Am Acad Dermatol, 75/6, Olsen EA, Canfield D., SALT II: a new take on the Severity of Alopecia Tool (SALT) for determining percentage scalp hair loss, 1268-1270, Copyright 2016, with permission from Elsevier.

Examples of Scalp Hair Loss at Varying SALT Scores

SALT Score 131

13% scalp hair loss

SALT Score 202

20% scalp hair loss

SALT Score 643

64% scalp hair loss

SALT Score 1004

100% scalp hair loss

References: 1. Grenier P, Veillette H. JAAD Case Rep. 2017;3(2):140-142. 2. Cho SK, Craiglow BG. JAAD Case Rep. 2021;16:82-85. 3. Kiszewski AE, et al. Int J Trichology. 2018;10(3):99-102. 4. Crispin MK, et al. JCI Insight. 2016;1(15):e89776.

Alopecia Areata (AA) Scale

The AA Scale is a recently developed severity scale that uses the extent of scalp hair loss as the primary basis for a severity rating, in addition to 4 secondary clinical features.1

The AA Scale was developed as a result of an academic–industry collaborative effort, including Pfizer Inc.

AA Scale

Rate severity of AA scalp hair loss using the table below:

Mild AA 20% or less scalp hair loss

Moderate AA 21%-49% scalp hair loss

Severe AA 50%-100% scalp hair loss

If mild or moderate, increase AA severity rating by 1 level if 1 or more of the following is present:

Noticeable eyebrow and eyelash involvement

Inadequate response after at least 6 months of treatment

Diffuse (multifocal) positive hair pull test consistent with rapidly progressive AA

Negative impact on psychosocial functioning resulting from AA

Evaluating AA Severity

Download a resource on calculating the extent of scalp hair loss (SALT score) and classifying AA severity (AA Scale).

DOWNLOAD

References: 1. King BA, Mesinkovska NA, Craiglow B, et al. Development of the alopecia areata scale for clinical use: results of an academic–industry collaborative effort. J Am Acad Dermatol. 2022;86(2):359-364. 2. Olsen EA, Hordinsky MK, Price VH, et al. Alopecia areata investigational assessment guidelines–part II. National Alopecia Areata Foundation. J Am Acad Dermatol. 2004;51(3):440-447. 3. Olsen EA, Canfield D. SALT II: A new take on the severity of alopecia tool (SALT) for determining percentage scalp hair loss. J Am Acad Dermatol. 2016;75(6):1268-1270. 4. Kennedy Crispin M, Ko JM, Craiglow BG, et al. Safety and efficacy of the JAK inhibitor tofacitinib citrate in patients with alopecia areata. JCI Insight. 2016;1(15):e89776. 5. Ibrahim O, Bayart CB, Hogan S, Piliang M, Bergfeld WF. Treatment of alopecia areata with tofacitinib. JAMA Dermatol. 2017;153(6):600-602. 6. Grenier PO, Veillette H. Treatment of alopecia universalis with oral alitretinoin: a case report. JAAD Case Rep. 2017;3(2):140-142. 7. Stallings AM, Velez MW, Fiessinger LA, et al. ILK index and regrowth in alopecia areata. J Investig Dermatol Symp Proc. 2015;17(2):47-49.