There are several tools that can help you assess the severity of Alopecia Areata1,2:

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

Alopecia Areata Investigator's Global Assessment™ (AA-IGA™) is used to assess the severity of scalp hair loss based on SALT scores5

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

There are no established US guidelines regarding disease severity in AA.

This overview does not include all available assessment tools; additional options exist for assessing patients in your practice.

The AA-IGA™ is a trademark owned by Eli Lilly and Company.

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

Alopecia Areata Investigator's Global Assessment™ (AA-IGA™) is used to assess the severity of scalp hair loss based on SALT scores5

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

There are no established US guidelines regarding disease severity in AA.

This overview does not include all available assessment tools; additional options exist for assessing patients in your practice.

The AA-IGA™ is a trademark owned by Eli Lilly and Company.

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 by2:

  • 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 loss2

Minimum SALT score of 0 indicates no hair loss2

*Used with permission.

†Reprinted from Olsen EA, Canfield D. J Am Acad Dermatol. 2016;75(6):1268-1270, copyright 2016, with permission from Elsevier.

Examples of Scalp Hair Loss at Varying SALT Scores

SALT Score 136

13% scalp hair loss

SALT Score 647

64% scalp hair loss

SALT Score 1004

100% scalp hair loss

Alopecia Areata Investigator's Global AssessmentTM (AA-IGATM)

The assessment determines severity thresholds solely based on SALT scores.5

AA-IGATM

A severity categorization based on a SALT score, where 50 to 94 is defined as Severe and 95 to 100 as Very Severe.5

SALT SCORE SCALP HAIR LOSS

0 None (0)
1-20 Limited (1)
21-49 Moderate (2)
50-94 Severe (3)
95-100 Very Severe (4)

AA-IGATM  is a validated assessment tool.

Alopecia Areata (AA) Scale

The AA Scale is a 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

It was developed and endorsed by a third-party consortium of 22 AA clinical experts with industry feedback, including Pfizer, and has not been used in clinical trials.

AA Scale

Identify extent of 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

Increase AA severity rating by 1 level if one 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

References: 1. King BA, Mesinkovska NA, Craiglow B, et al. J Am Acad Dermatol. 2022;86(2):359-364. 2. Olsen EA, Hordinsky MK, Price VH, et al; National Alopecia Areata Foundation. J Am Acad Dermatol. 2004;51(3):440-447. 3. Olsen EA, Canfield D. J Am Acad Dermatol. 2016;75(6):1268-1270. 4. Kennedy Crispin M, Ko JM, Craiglow BG, et al. JCI Insight. 2016;1(15):e89776. 5. Wyrwich KW, Kitchen H, Knight S, et al. Br J Dermatol. 2020;183(4):702-709. 6. Grenier P, Veillette H. JAAD Case Rep. 2017;3(2):140-142. 7. Kiszewski AB, Bevilaqua M, de Abreu LB. Int J Trichology. 2018;10(3):99-102.