Advertisement

A new classification of pattern hair loss that is universal for men and women: Basic and specific (BASP) classification

      Background

      Pattern hair loss (PHL) can be classified into several patterns. Currently, the Hamilton–Norwood classification system for men and the Ludwig grade system for women are commonly used to describe patterns of hair loss. However, these pre-existing classifications have some limitations.

      Objective

      To establish an acceptable, universal, and accurate standard of both male and female pattern hair loss and to report its use in determining the incidence of PHL.

      Methods

      We developed a new classification system (BASP classification) and then applied this system to classify the types of PHL. The BASP classification was based on observed patterns of hair loss. The basic (BA) types represent the shape of the anterior hairline, and the specific types (SP) represent the density of hair on distinct areas (frontal and vertex). There are four basic types (L, M, C, and U) and two specific types (F and V). The final type is decided by the combination of the assigned basic and specific types. Between November 2004 and June 2005, 2213 Korean subjects, comprised of 1768 males and 445 females, were classified according to the BASP classification at 13 university dermatologic centers nationwide throughout South Korea, as a multicenter study of the Korean Hair Research Society.

      Results

      For both sexes, the majority of patients enrolled in the study were in the third and fourth decade of life (65.1% of males and 56.68% of females). In males, the older group as well as the younger group in the study were more likely to have little recession of the frontal hairline (classified as type M1∼2) and diffuse thinning over the top of scalp (type F1∼2). The women in the study developed typical female PHL.

      Limitations

      The subjects of our study were mostly outpatients and some inpatients who complained about hair loss, not the general population of Korea.

      Conclusion

      The BASP classification is a new stepwise, systematic, and universal classification system for PHL, regardless of sex.
      To read this article in full you will need to make a payment
      AAD Member Login
      AAD Members, full access to the journal is a member benefit. Use your society credentials to access all journal content and features
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Beek C.H.
        A study on extension and distribution of the human body-hair.
        Dermatologica. 1950; 101: 317-331
        • Hamilton J.B.
        Patterned loss of hair in man; types and incidence.
        Ann N Y Acad Sci. 1951; 53: 708-728
        • Norwood O.T.
        Male pattern baldness: classification and incidence.
        South Med J. 1975; 68: 1359-1365
        • Kaufman K.D.
        • Olsen E.A.
        • Whiting D.
        • Savin R.
        • DeVillez R.
        • Bergfeld W.
        • et al.
        Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group.
        J Am Acad Dermatol. 1998; 39: 578-589
        • Savin R.C.
        A method for visually describing and quantitating hair loss in male pattern baldness.
        J Invest Dermatol. 1992; 98 ([abstract]): 604
        • Olsen E.A.
        The midline part: an important physical clue to the clinical diagnosis of androgenetic alopecia in women.
        J Am Acad Dermatol. 1999; 40: 106-109
        • Hornung R.L.
        • Rhodes T.
        • West D.P.
        • Aasi S.Z.
        • Girman C.J.
        Interrater agreement of Savin density and pattern scales for male pattern hair loss.
        J Invest Dermatol. 2000; 114: 887
        • Olsen E.A.
        Female pattern hair loss.
        J Am Acad Dermatol. 2001; 45: S70-S80
        • Olsen E.A.
        Current and novel methods for assessing efficacy of hair growth promoters in pattern hair loss.
        J Am Acad Dermatol. 2003; 48: 253-262
        • Olsen E.A.
        • Canfield D.
        • Canfield W.
        • Budris K.
        A novel method for assessing regional scalp hair density in male pattern hair loss.
        in: Van Neste D. Hair science and technology. McGraw-Hill, New York2003: 251-254
        • Ludwig E.
        Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex.
        Br J Dermatol. 1977; 97: 247-254
        • Olsen E.A.
        Androgenetic alopecia.
        in: Olsen E.A. Disorders of hair growth: diagnosis and treatment. McGraw-Hill, New York1994: 257-283
        • Bouhanna P.
        • Nataf J.
        A propos des transplantations de cuir chevelu: critiques et propositions.
        Rev Chir Esthet. 1976; 7 ([in French]): 17-23
        • Bouhanna P.
        Multifactorial classification of male and female androgenetic alopecia.
        Dermatol Surg. 2000; 26: 555-561
        • Koo S.-H.
        • Chung H.-S.
        • Yoon E.-S.
        • Park S.-H.
        A new classification of male pattern baldness and a clinical study of the anterior hairline.
        Aesthetic Plastic Surg. 2000; 24: 46-51
        • Orentreich N.
        Pathogenesis of alopecia.
        J Soc Cosmet Chemists. 1960; 11: 479-499
        • Ludwig E.
        Androgenetic alopecia.
        Arch Dermatol. 1977; 113: 109
        • Price V.H.
        Androgenetic alopecia.
        Arch Dermatol. 1977; 113: 109-110
        • Setty L.R.
        Hair patterns of scalp of white and Negro males.
        Am J Phys Anthropol. 1970; 33: 49-55
        • Paik J.H.
        • Yoon J.B.
        • Sim W.Y.
        • Kim B.S.
        • Kim N.I.
        The prevalence and types of androgenetic alopecia in Korean men and women.
        Br J Dermatol. 2001; 145: 95-99
        • Pathomvanich D.
        • Pongratananukul S.
        • Thienthaworn P.
        • Manoshai S.
        A random study of Asian male androgenetic alopecia in Bangkok, Thailand.
        Dermatol Surg. 2002; 28: 804-807
        • Takashima I.
        • Iju M.
        • Sudo M.
        Alopecia androgenetica—its incidence in Japanese and associated conditions.
        in: Orfanos C.E. Montagna W. Stuttgen G. Hair researsh; status and future aspects. Springer-Verlag, Berlin1981: 287-293
        • Price V.H.
        Androgenetic alopecia in women.
        J Invest Dermatol Symp Proc. 2003; 8: 24-27
        • Norwood O.T.
        Incidence of female androgenetic alopecia (female pattern alopecia).
        Dermatol Surg. 2001; 27: 53-54
        • Cash T.F.
        • Price V.H.
        • Savin R.C.
        Psychological effects of androgenetic alopecia on women: comparisons with balding men and with female control subjects.
        J Am Acad Dermatol. 1993; 29: 568-575