What the SALT Score Can (and Can’t) Tell You About Alopecia Areata

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By Staff
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Why is it worth knowing your SALT score (especially if you can see the hair loss just by looking in the mirror)? First, it can give you an objective measure of how well treatment is working — or not working.

Here’s why that’s important: After you’ve been on therapy for a certain amount of time — typically three to five months — your dermatologist can do another SALT test to see how your numbers have changed. From there, you can decide if it’s worth staying on the current treatment or if you should try something else.

Speaking of treatment, you might need a SALT score to get started on medication in the first place. “In order to approve a drug for the treatment of alopecia areata, some insurance companies may require the SALT score to document disease severity and support why a treatment is medically necessary,” says Dr. Camp.

The SALT score has some shortcomings to keep in mind, though. The tool doesn’t factor in hair loss beyond the scalp. It also doesn’t account for the mental or emotional impact of alopecia, such as feeling embarrassed about hair loss or anxious about wearing a wig in public.
To address these downsides, experts have developed other alopecia severity tests. The Alopecia Areata Scale, for instance, looks at scalp hair loss, body hair loss, and the psychosocial effects of the condition (for example, whether it stops you from going out or causes depression).

“Other ways to assess and monitor a person’s disease severity include photographic documentation or descriptive measurements, such as mild, moderate, or severe,” says Camp.

If you have questions about the SALT score or other assessment tools, talk to your dermatologist. Together, you can decide on the best way to measure and track alopecia areata severity — and find the best treatment for you.

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