Stages of female hair loss

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Hair loss in women can be classified into diffuse hair loss, localized hair loss, or patterned hair loss.


It can also be divided into scarring and non-scarring types. Since the diffuse, non-scarring female hair loss is so common, it has its own special classification to indicate the amount and degree of thinning, called the Ludwig classification.


The Ludwig Classification uses three stages to describe female pattern genetic hair loss: Type I (mild), Type II (moderate), Type III (extensive).


In all three Ludwig stages, there is hair loss on the front and top of the scalp. The frontal hairline is usually preserved, and the back and sides of the head may or may not be involved.


Only women who have stable hair on the back and sides of the scalp, that isn’t thinning at all, are candidates for hair transplant surgery.



Ludwig Hair Loss Classification in Women



Women may also present with Diffuse Hair loss. The cause of this type of hair loss has multiple etiologic factors and will always mandate further investigation in order to exclude metabolic causes, such as Iron Deficiency, Thyroid disease, Telogen Effluvium and Polycystic Ovarian Syndrome (10% of women suffer from this). Other causes include heavy metal poisoning with Mercury, Thallium, Arsenic, Cadmium. Also, Biotin and Zinc deficiencies. Furthermore, Scarring Alopecias need to be excluded and often a Scalp Biopsy will be required to confirm the diagnosis via a Histologic Report from a dermato-pathologist.


Getting an accurate diagnosis is important before any specific treatment regime is started.


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