Today, we will talk about a specific area on the scalp that really bothers many people – the crown area, which is the top of the scalp. It is a common occurrence when I am asked to assess a patient’s crown area as there is concern that there is significant hair loss. But under dermatoscope examination, there is no evidence of miniaturisation or loss of density—none of the clinical findings associated with Androgenic Alopecia. But the area does look more sparse than, say, the frontal area. This effectively boils down to an optical illusion.
Understanding the Illusion of Emptiness in Dental Crowns
It all has to do with the direction of the hair. If we look at the front of the scalp as an example, the hair is layered in one direction in the front of the hairline. So as it comes forward, one on top of the other, it gives the sense of greater density more thickness as light cannot shine through the hair onto the scalp and reflect back onto your eyes. It’s this layering effect that really assists us in giving us that look or that optical illusion of greater density.
The issue with the crown is that most of us have what is known as a whirl which is just part of the design of the hair. Most people have one whirl, and some have two. What essentially happens is that the direction of the hair really dictates the whirl, and in that scenario, the hair flows in 360 degrees. You have the central portion, and from that hair flowing out in all 360 degrees and most people, it forms a spiral. It’s like a flower that opens up from the central part, and thus, this part becomes obviously more see-through. So people see that central portion and assume that it is more see-through due to hair loss when it is actually just a normal occurrence because the hair is opening out. When we are transplanting into that area, if you’ve already got some existing hair and just thinning out a little bit, we actually have to recreate that whirl as well.