Baseline trichoscopic values for afro-textured hair in indigenous South Africans show lower density and unique features.

Background: Afro-textured hair exhibits distinct physicochemical properties with possible variations in measurable hair parameters. Standardized documentation of trichoscopic norms of afro-textured hair in indigenous Africans is notably lacking.

Methods: A cross-sectional study involving 122 South Africans of both genders of African ancestry (mean age 20.9 ± 3.3 years) with natural afro-textured hair was performed to establish trichoscopic norms. Standard images, one overview, and five microimages (one 20× and four 50× magnifications) were captured with the FotoFinder Medicam1000V2 videodermoscope. Hair density (HD; N/cm²); hair shaft thickness (HST; μm); the proportion of thin, mid, and thick hairs (%); cumulative hair thickness (mm/cm²); and follicular units (FU; N/cm²) were assessed.

Results: The average HD was 139.1 ± 33.88 hairs/cm² with significant variations across different scalp areas. The average hair thickness was 62.59 ± 8.45 μm with the frontal scalp showing the greatest HST, the proportion of thick hairs, cumulative hair thickness, and FU densities; the temporal had the greatest proportion of thin hairs, whereas the occipital showed the highest proportion of triple hair FU. Male participants exhibited significantly greater average hair thickness, more thick hairs, and more double and triple FU, whereas females had higher cumulative hair thickness density, more thin and intermediate hairs, and more single follicular units.

Conclusion: Baseline trichoscopic values for natural afro-textured hair in indigenous South Africans reveal lower hair densities, variations in shaft diameters, and follicular unit patterns compared to other racial groups. Significant gender-based differences are evident in some of the measured parameters. Tailored reference values are essential for accurate clinical evaluations and hair transplant planning.