Modified basic and specific (BASP) classification for pattern hair loss

Abstract

Background In 2007, Lee et al. introduced a basic and specific (BASP) classification for pattern hair loss that was comprehensive and applicable regardless of race or gender. However, this BASP classification has several limitations. Frontal type hair loss classification is relatively crude, and a specific hair loss pattern cannot be ascertained when hair loss is associated with the temporal and occipital areas. Methods In our modified BASP classification, frontal type classification was subdivided into five instead of three grades. Basic type classification remained the same as in the previous method. In addition, information regarding the involvement of the temporal or occipital scalp was recorded. Accuracy and ease of use were evaluated and compared with the existing BASP classification in 138 patients with pattern hair loss. Results Temporal or occipital involvement was observed in 14 patients, accounting for 11.1% of subjects. Final type accuracy was 82.5% in the existing BASP classification and 71.4% in the modified classification. Ease of use for two practitioners was 70.2 and 72.1% for the existing BASP classification, and 48.9 and 52.2% for the modified method. Conclusion We expect that the modified BASP classification will overcome the limitations of the existing BASP classification. We believe this modified classification will be a valuable tool for pattern hair loss classification because of its classification of previously unclassified types.

Quantitative measurement of hair diameter diversity as a diagnostic indicator of androgenetic alopecia in Korean males: A cross-sectional study

“…6 However, the original definition of HDD ≥20% was not explicitly detailed, leading to an interpretation in subsequent studies that it involved cases where more than 20% of hairs are less than 40 μm in diameter. 2 , 4 , 20 Our in-depth evaluation at a fixed 20% HDD cutoff revealed that a 45-μm threshold offers superior diagnostic performance for the Korean population, marked by the highest Youden index. This is particularly relevant considering that Korean individuals typically have thicker hair compared to those of Caucasian ethnicity.…”

“…Furthermore, using a specific hair diameter threshold may not account for individual variations in hair thickness, highlighting the need for a more personalized diagnostic approach. Diagnostic assessments for AGA often rely on established clinical scales like the Norwood-Hamilton, Ludwig, and BASP classifications, 2 , 6 , 22 which, despite their ease of use and intuitive nature, are limited by their subjective quantification of the condition. 19 Future research should explore the correlation between physicians' perceptions of HDD and its quantitative measurements to address these subjective aspects.…”

“…Androgenetic alopecia (AGA), the predominant form of baldness often referred to as pattern hair loss, causes individuals to commonly exhibit an abundance of thin hairs. 1 , 2 , 3 , 4 , 5 Traditionally, AGA diagnosis has not relied on precise and objective measurements, instead, clinicians have commonly relied on subjective judgment using severity classification tools such as the Norwood-Hamilton, Ludwig, or the basic and specific (BASP) classification. 2 Introduced in 2001, the concept of increased hair diameter diversity (HDD) is recognized as a critical objective clinical sign in diagnosing AGA, particularly due to its association with hair follicle miniaturization.…”

“… 1 , 2 , 3 , 4 , 5 Traditionally, AGA diagnosis has not relied on precise and objective measurements, instead, clinicians have commonly relied on subjective judgment using severity classification tools such as the Norwood-Hamilton, Ludwig, or the basic and specific (BASP) classification. 2 Introduced in 2001, the concept of increased hair diameter diversity (HDD) is recognized as a critical objective clinical sign in diagnosing AGA, particularly due to its association with hair follicle miniaturization. 6 Since hair follicle miniaturization stands central to AGA, HDD serves as a pivotal and easily understandable indicator of this phenomenon.…”

Frequency of Different Pattern of Hair Loss in Pakistani Men Using BASP Classification

“…18 The new BASP classification will not only facilitates in the development of a unified and simplified algorithm, but also help formulates treatment guideline. [19][20]…”