I've had this helmet (in gray, of course) since 2011. I'm a little ashamed to admit it, but I have a pin head. No doubt it's crammed full with a dense and incredibly efficient brain, hence the headaches, but it does create a problem when finding helmets that fit properly. I really hate looking like an 8 year old girl on a barbie bike with handle bar tassels while a bowling ball that's been chopped in half, painted like a ladybug, and passed off as a helmet sits so far back on her head there is actual danger the chin strap might at any moment constrict her esophagus and cause an untimely death. But that is often the case with One-size-fits-all helmets for me. Don't get me wrong, I'm a proud supporter of girls on bikes, even pink bikes, but loose fitting helmets suck. I say loose instead of poorly fitting because I've never really experienced a helmet that was too tight.
The small size in the Altios fits me pretty damn well. The quick-adjust wheel knob deelie works well with one hand when switching between wearing a hat under the helmet and not. I've used the helmet on rock, ice, and glacier and I have been pleased by it's performance, if sitting in one place all day, attempting to not get noticed can be considered a performance. I haven't taken any major falling objects to the head while wearing this helmet but I have been pretty rough with it and it still looks almost new after 3 years. I wish I could say the same for the fading Justin Bieber stickers. The hybrid suspension system is very comfortable and has allowed for more ventilation than non-suspension helmets. I used the past tense for the ventilation because over time the suspension has relaxed/streched and now sits on the foam. I don't notice this from either a comfort or ventilation stand point but I think it's worth noting. The one other thing I'm not super stoked about on the Altios is the side straps that go around your ears do not have any length adjustment. The chin strap does and that buckle works alright, but I've found that the side straps can end up biting into the bottom of my ear over time. It only happens on one side because of course God thought it would be a good idea to make my ears lop-sided.
Overall I would say I've been very pleased with how the Altios has held up over the years and how it only rarely made its presence known over a long day in the mountains. That being said, it's not the lightest helmet on the market and I think, depending on fit of course, I'm going to be looking to a foam helmet in the future. Something like the BD Vapor or the Petzl Sirocco, but only if they change that heinous color.