Most hair loss occurs gradually and in a predictable pattern. To help diagnose your hair loss pattern and recommend the right solution, doctors use classification systems to determine the stage of your hair loss. Knowing what stage your hair loss is at can help as you research your hair restoration options.
Since the stages of hair loss are often different between men and women, there are different classification scales used for each: the Norwood scale (male) and the Ludwig scale (female). We’ll discuss both in more detail below.
The Progression of Male Hair Loss
Male pattern baldness usually appears along your hairline, resulting in an “M” shape to your hair. Gradually, your mid-crown hair becomes shorter and finer until a bald patch appears. Identifying this pattern, along with an assessment of your family medical history, can help your Bosley physician diagnose your type of hair loss.
If your hair loss doesn’t conform to this pattern, it may be caused by a condition other than male pattern baldness. If you’ve experienced sudden hair loss (either in patches or all at once); hair that’s brittle and breaks easily; or hair loss coupled with scaling, pain, or redness, you should talk to your physician to determine the cause.
Male Baldness: The Norwood Scale
Developed by Dr. James Hamilton (and later updated by Dr. O’tar Norwood), the Norwood scale consists of seven stages of hair loss:
- Class 1 represents a head of hair with no visible hair loss.
- Class 2 is characterized by the beginning of a receding hairline and a “widow’s peak” on the forehead.
- Class 3 patients exhibit a more significant decline in hair above the temples as well as hair receding from the forehead. Hair loss is also starting to become significant on the crown.
- Class 4 hair loss may become more noticeable on the crown, or patients may have significant hair loss above the temples and/or front anterior areas.
- Class 5 hair loss approaches significant levels, with most hair loss occurring on the vertex and crown.
- Class 6 patients show major hair loss but still have areas with donor hair available. Transplanting at this stage of hair loss can still have excellent results.
- Class 7 patients show the most significant loss of hair. There may still be sufficient donor hair for transplantation; however, results may be limited.
The Progression of Female Hair Loss
For women, hair loss progresses differently from that of men. Typically, women lose hair from the top of the head, causing the part to become wider as the hair loss progresses.
Identifying this pattern, along with assessing your family medical history, can help your Bosley physician diagnose your type of hair loss and recommend the best treatment plan for you.
Female Baldness: The Ludwig Scale
Female pattern hair loss is traditionally classified using the Ludwig scale, which divides the stages of genetic hair loss into three types:
- Type 1 is the least severe stage of female hair loss, with thinning starting on the top of the head.
- Type 2 hair loss is more significant, with areas of the scalp showing through thinning hair.
- Type 3 patients have complete hair loss on the crown of the head. However, if enough donor hair still exists, they still may be good candidates for hair restoration.