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

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

What the SALT Score Can (and Can’t) Tell You About Alopecia Areata
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Published on November 25, 2025
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Using a New Alopecia Areata Severity Score to Expand Access to Care

SALT scores have long been used to determine severity of alopecia areata, but they often fall short in assessing the condition.
Using a New Alopecia Areata Severity Score to Expand Access to Care

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If you have alopecia areata, your doctor may be able to estimate the level of hair loss simply by looking at your scalp. But they may also use a test called the Severity of Alopecia Tool, commonly called SALT.

Your score on the SALT test can give you a clearer sense of how much hair you’ve lost and how much has grown back after starting treatment.

Here’s how the SALT score works — and what it can and can’t tell you about hair loss.

What Is the SALT Score?

The SALT test is a standardized method for determining the amount of scalp hair loss in people with alopecia areata. Performed by a dermatologist, it can measure how severe the alopecia is on a scale of 0 to 100. A score of 0 indicates no scalp hair loss, while a score of 100 indicates complete scalp hair loss.

Your doctor can conduct a SALT test during an in-office appointment. They’ll start by dividing your scalp into four regions, or quadrants: the front, back, right side, and left side. Then they’ll visually examine the hair loss in each quadrant.

From there, your doctor will calculate a weighted average of hair loss from each quadrant to determine the total percentage of hair loss for your entire scalp.

 It only takes a few minutes to calculate, says Brendan Camp, MD, a double board-certified dermatologist at MDCS Dermatology in New York City.

What Your Score Means

The higher the number, the more scalp hair loss — and the more severe the alopecia is considered. That said, SALT only tells you what’s happening on your head. The test doesn’t look at other hair loss, such as on your eyebrows and eyelashes or other parts of your body.

The National Alopecia Areata Foundation classifies the extent of hair loss as:

  • 0–20: Mild alopecia areata (a score of 0 means no hair loss and completely inactive disease)

  • 21–49: Moderate alopecia areata
  • 50–100: Severe alopecia areata
Having a SALT score of 20 or higher means you’re likely a good candidate for systemic (not topical) treatments that can help restore hair growth.

If you’re already being treated for alopecia, your SALT score can also give you and your dermatologist an objective measure of how treatment is working. Medications are usually considered a success if they curb hair loss by at least 50 percent.

How the SALT Score Is Used

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.

The Takeaway

  • The SALT test is used to determine the severity of scalp hair loss in people with alopecia areata.
  • The SALT test uses a scale of 0 to 100, with a score of 0 indicating no scalp hair loss and a score of 100 indicating complete scalp hair loss.
  • Your SALT score can help you and your doctor determine the best treatment for you and keep tabs on how well it’s working. It may also be necessary if you want insurance to cover medication costs.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Apalla Z et al. Clinical Assessment of Alopecia Areata Severity and Validating the Patient Experience: A Vodcast. American Journal of Clinical Dermatology. November 2025.
  2. Determining Alopecia Areata Severity. National Alopecia Areata Foundation.
  3. Donovan J. Complete Responses and SALT Zero Scores in Alopecia Areata: Not the Same. Journal of Dermatological Treatment. 2024.
  4. King BA et al. Defining Severity in Alopecia Areata: Current Perspectives and a Multidimensional Framework. Dermatology and Therapy (Heidelberg). April 2022.
  5. King BA et al. Development of the Alopecia Areata Scale for Clinical Use: Results of an Academic-Industry Collaborative Effort. Journal of the American Academy of Dermatology. February 2022.
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Oyetewa Asempa, MD, FAAD

Medical Reviewer

Dr. Oyetewa Asempa is an assistant professor of dermatology at Baylor College of Medicine, and the director of the Skin of Color Clinic for Baylor's department of dermatology. She was born and raised in Atlanta and then went on to graduate summa cum laude from Howard University in Washington, DC.

She completed her medical training at University of Illinois at Chicago College of Medicine, during which time she also completed a year of research at the National Institutes of Health. She completed her internship at George Washington University, and then her residency training at the Harvard dermatology program, where she served as chief resident in her final year.

She specializes in hair loss and scalp disorders, as well as pigmentary disorders in patients of color. She has spoken at multiple national conferences. Outside of medicine, she enjoys writing short stories, as well as writing and performing spoken word poetry.

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Marygrace Taylor

Marygrace Taylor

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Marygrace Taylor is an award-winning freelance health and wellness writer with more than 15 years of experience covering topics including women’s health, nutrition, chronic conditions, and preventive medicine. Her work has appeared in top national outlets like Prevention, Parade, Women’s Health, and O, The Oprah Magazine.

She's also the coauthor of three books: Eat Clean, Stay Lean: The Diet, Prevention Mediterranean Table, and Allergy-Friendly Food for Families. She lives in Philadelphia.

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