Precise Scale: A Quantitative Classification for Androgenetic Alopecia and Its Application to Hair Transplantation

June 2023 in “ Aesthetic Plastic Surgery ”

Felipe José Monassa Pittella, Claudia Castro, Roberto Trivellini, Pradeep Sethi, Simone La Padula, Baltazar Dias Sanabria, Camila Quinetti Paes, Miguel G. S. Palmieri, Frederico Pittella

androgenetic alopecia hair transplantation grafts LiDAR TrueDepth 3D modeling miniaturized areas Relative Bald Area telehealth hair follicles donor areas coverage value hair diameter index baldness hair transplant 3D scanning bald spots remote health hair thickness

Studysummary This study introduces the PRECISE scale, a quantitative tool to classify androgenetic alopecia, aiming to improve planning and outcomes for hair transplantation surgeries by evaluating the whole hairless and thinning areas.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The PRECISE scale is a quantitative classification system for androgenetic alopecia that estimates the number of grafts needed for hair transplantation. It uses a 0-10 rating and recommends 1500 grafts for each point on the scale. The scale measures hairless and thinning areas, using techniques like LiDAR/TrueDepth technologies for 3D modeling, and applies a correction factor for miniaturized areas. The Relative Bald Area (RBA) is crucial for classification. The scale can be used in telehealth and is expected to have good reproducibility. For instance, a PRECISE class 5 would need 7500 grafts, possibly requiring 2 or 3 procedures. However, the surgeon must consider the patient's available resources, such as the availability of hair follicles in donor areas. Future studies aim to validate the scale's reproducibility and its correlation with the coverage value and the hair diameter index.

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Research cited in this study

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research The Development and Application of the Hair Diameter Index (HDI)

3 citations , January 2021 in “Hair transplant forum international”

This study found that visual hair density is better correlated with hair count and shaft diameter, leading to the development of the Hair Diameter Index used in planning hair restoration procedures.

research Trichoscopic Findings in Androgenetic Alopecia

3 citations , January 2021 in “Medicinski arhiv”

In this study, trichoscopic examination revealed that patients with androgenetic alopecia had significantly more yellow dots, pilosebaceous units with one hair, and increased perifollicular hyperpigmentation compared to healthy controls.

research Classification of Male-Pattern Hair Loss

9 citations , January 2017 in “International Journal of Trichology”

This review discusses various classification systems for male-pattern hair loss, comparing their detail, practicality, and reproducibility, and reports no new clinical outcomes.

research Classifications of Patterned Hair Loss: A Review

101 citations , January 2016 in “Journal of Cutaneous and Aesthetic Surgery”

This review discusses various classification systems for patterned hair loss in both sexes and reports no new clinical findings, highlighting the Hamilton-Norwood and Ludwig systems as the most commonly used.

research Androgenetic Alopecia: New Insights Into the Pathogenesis and Mechanism of Hair Loss

33 citations , August 2015 in “F1000Research”

This study presents a new model for androgenetic alopecia progression, explaining diffuse hair loss in women through 3D reconstructions of the arrector pili muscle and its relationship with the hair follicle stem cell niche.

research Quantitative Assessment of Female Pattern Hair Loss

5 citations , February 2015 in “Dermatologica Sinica”

In this study, a computer-aided imaging system accurately measured the width of balding areas in female pattern hair loss, correlating strongly with clinical staging severity.

research A New Classification of Pattern Hair Loss That Is Universal for Men and Women: Basic and Specific (BASP) Classification

125 citations , May 2007 in “Journal of The American Academy of Dermatology”

This study describes the development of the BASP classification system, providing a universal and systematic approach for classifying pattern hair loss in both men and women.

Hair Diameter Diversity: A Clinical Sign Reflecting Follicle Miniaturization

Precise Scale: A Quantitative Classification for Androgenetic Alopecia and Its Application to Hair Transplantation

Research cited in this study

research The Development and Application of the Hair Diameter Index (HDI)

research Trichoscopic Findings in Androgenetic Alopecia

research Classification of Male-Pattern Hair Loss

research Classifications of Patterned Hair Loss: A Review

research Androgenetic Alopecia: New Insights Into the Pathogenesis and Mechanism of Hair Loss

research Quantitative Assessment of Female Pattern Hair Loss

research A New Classification of Pattern Hair Loss That Is Universal for Men and Women: Basic and Specific (BASP) Classification

research Hair Diameter Diversity: A Clinical Sign Reflecting Follicle Miniaturization

research Multifactorial Classification of Male and Female Androgenetic Alopecia

research A New Classification of Male Pattern Baldness and a Clinical Study of the Anterior Hairline

research Classification of the Types of Androgenetic Alopecia (Common Baldness) Occurring in the Female Sex