Dr Headington and the Horizontally Sectioned Punch Biopsy Specimen

Horizontal vs Vertical Sections: What Changed in 1984?

Dr Terry Headington changed the way the hair loss community thinks about processing scalp biopsies. His landmark paper in 1984 encouraged the field to start thinking about the benefits of processing biopsies horizontally as opposed to vertically. Horizontal sectioning (also called transverse sectioning) has become a mainstay of dermatopathology alopecia assessments in many parts of the world.

Both vertical and horizontal sectioning have advantages and disadvantages but horizontal sections offer unique advantages with respect to assessment of hair counts, assessment of sebaceous gland atrophy and size, terminal to vellus ratio, anagen to telogen ratios, catagen and telogen proportions …. and more.

REFERENCE

Headington JT. Transverse microscopic anatomy of the human scalp. A basis for a morphometric approach to disorders of the hair follicle. Arch Dermatol. 1984;120(4): 449-456.