Second-to-fourth digit ratio and age predicting the severity of androgenetic alopecia: a cross-sectional study

Purpose: Androgenetic alopecia (AGA) is a common type of hair loss. Previous studies indicated that the relative length of the index and ring finger (2D:4D ratio) of AGA patients was lower than control. However, the correlation between 2D:4D ratio and disease severity is unclear. In this study, we sought to evaluate the relationship between digit ratio of the right hand and AGA severity in male patients.Materials and methods: The cross-sectional study was performed. Hamilton-Norwood scale was used to assess severity. The finger lengths of the right hand were measured using a digital caliper.Results: Our study found that the lower the right-handed 2D:4D ratio, the greater the risk of developing AGA and that the severity of AGA increases with age. Patients with moderate and severe AGA (grade 3 and above) had lower 2D:4D ratios and higher average age compared with patients with mild AGA (Norwood grade 2). Patients aged ≥37.5 with a 2D:4D ratio <0.947 were six times more likely to have moderate-to-severe androgenetic alopecia compared with the reference group (OR: 6.11; 95% CI: 1.96-19.04).Conclusions: Combining 2D:4D ratio and older age may help predict the severity risk of AGA, and offer a clinically accessible, non-invasive approach for patients to easily predict their future severity.