S1 Guideline for Diagnostic Evaluation in Androgenetic Alopecia in Men, Women and Adolescents

U. Blume-Peytavi; A. Blumeyer; A. Tosti; A. Finner; V. Marmol; M. Trakatelli; P. Reygagne; A. Messenger


The British Journal of Dermatology. 2011;164(1):5-15. 

In This Article

Abstract and Introduction


Androgenetic alopecia (AGA) is the most common hair loss disorder, affecting both men and women. Due to the frequency and the often significant impairment of life perceived by the affected patients, competent advice, diagnosis and treatment is particularly important. As evidence-based guidelines on hair disorders are rare, a European consensus group was constituted to develop guidelines for the diagnostic evaluation and treatment of AGA. This S1 guideline for diagnostic evaluation of AGA in men, women and adolescents reviews the definition of AGA and presents expert opinion-based recommendations for sex-dependent steps in the diagnostic procedure.


Evidence-based guidelines on hair disorders are rare, except for one S2 guideline on alopecia areata by the British Association of Dermatologists.[1] No national, European or international guidelines have been established for the diagnosis and treatment of androgenetic alopecia (AGA). Three different types of evidence-based guidelines (types S1–S3) exist. An S1 guideline is built by an informal consensus of an expert group. The statements for S2 guidelines are formed by a formal consensus process. An S3 guideline is based on a consensus from a systematic literature research with evaluation of evidence levels and a systematic decision process.

A European consensus group was built, consisting of members from different countries, organizations, specialities and interest groups. A detailed literature search on diagnosis and treatment of AGA using Medline, Embase, Cochrane and a hand search was performed. Based on the literature available the group decided to undergo an informal consensus process on an S1 level for the diagnosis of AGA and an S3 guideline process for the therapy of AGA (published separately). A subgroup of this European Consensus Group consisting of the eight authors of this article decided to work on this S1 guideline which was funded by the Verein Pro Haut e.V. Berlin, and is therefore independent and without any commercial conflict of interest.

The European Consensus Group reviewed the definition of AGA and established a consensus for the diagnosis of AGA dealing with the following points: expert opinion-based recommendation for the diagnosis of AGA in female and male patients, as well as in adolescents. The aim was to develop a diagnostic evaluation form and recommendations for diagnostic procedures to assist in the daily work of the practitioner. The questionnaire for daily practice was kept simple and it is planned to be validated during consultation by practising dermatologists experienced in the management of hair disorders.


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