title: The Ziering whorl classification of scalp hair.
abstract: BACKGROUND
  Although easily recognized, the whorl has never been formally studied or observed for similarities among individuals and ethnic groups.
  
  
  OBJECTIVE
  To standardize terminology, define the anatomic location, develop a classification system, and determine ethnic variability of the scalp whorl.
  
  
  METHODS
  We retrospectively reviewed digital photographs of 534 patients, men and women. From these photos, patterns and variation in the whorl were determined. Then the data were separated by gender and race. Five different racial groups were identified: White, African American, Hispanic, Asian, and South Asian. If alopecia was so severe that no pattern was clearly identified, they were listed as indeterminate.
  
  
  RESULTS
  Five distinct natural whorl patterns were identified. There was limited variation in these patterns, mostly involving tightness and direction of the spiral. White males have the most distinct whorls. Conversely, African Americans and women tend to have a diffusion pattern as opposed to a distinct whorl.
  
  
  CONCLUSIONS
  The whorl is an important part of the natural flow of the hair. It is our goal that this classification method can help surgeons identify and improve the surgical reconstruction of the whorl.
authors.affiliation: Ziering Medical, Beverly Hills, California 90211, USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Ziering
authors.forename: Gabriel
authors.initials: G
authors.lastname: Krenitsky
mesh_terms: D005006:Ethnicity; D005260:Female; D006197:Hair / Q000033:anatomy & histology; D006801:Humans; D008297:Male; D012189:Retrospective Studies