Clinical Assessment of the Scalp and Hair

Abstract

The most important aspect for assessing scalp hair clinically is to evaluate the density of hair and pattern of hair loss, if it exists. Various clinical classification systems have been proposed for describing hair density and pattern of hair loss to achieve this goal. These classification systems have several limitations in clinical practice. A new classification system of pattern hair loss, named the basic and specific (BASP) classification, which is comprehensive and systematic regardless of race or gender, was designed based on the pattern of hair loss, including the shape of the anterior hairline and the density of hair on the frontal and vertex areas. The BASP classification not only classifies all kinds of hair-loss patterns regardless of sex or race, but also has better reproducibility and repeatability than the Norwood-Hamilton classification. There are also racial differences in the density of hair and patterns of hair loss in different ethnic groups. Family history plays an important role in the hair density and pattern of hair loss, which is believed to be influenced by genetic factors. Familiar factor study using the BASP classification revealed that familial factors affecting the morphology of pattern hair loss differ between males and females and for each BASP subtype.