Hair Loss Diagnosis Archives - Cosmedica

From Hairline to Hair Loss: A Guide to Male Pattern Baldness

Written by: Fahmida Hoque Rimti — Tue, 30 Jan 2024 16:12:29 +0000

Androgenic alopecia is a hereditary hair loss condition that can affect men and women all over the world. It can manifest as male pattern baldness or, less commonly, as female pattern hair loss.

Despite the rarity of female pattern baldness, this genetic and hormonal-influenced condition can result in hair thinning, loss, and eventual balding in both genders. It is generally characterized by a receding hairline in men or a diffuse thinning over the crown for both men and women. In this blog post, we will focus our lens on the topic of hair loss in men and illustrate some possibilities.

What Are the Different Types of Hair Loss?

There are two main types of hair loss: Cicatricial alopecia and non-cicatricial alopecia. In Cicatricial alopecia, damaged follicles are replaced with fibrotic scar tissue, causing permanent hair loss. It is classified into two groups: Primary cicatricial alopecia (PCA) and secondary cicatricial alopecia (SCA).

Non-cicatricial alopecia, on the other hand, is a theoretically reversible alopecia characterized by an altered hair cycle and preserved hair follicles. They are divided into local alopecia and diffuse alopecia. Male pattern baldness or androgenic alopecia usually falls under diffuse alopecia. Types of diffuse alopecia commonly include:

Androgenic alopecia: This type of baldness generally manifests when the hair follicle shrinks. It is the most common type of hair loss in men and women.
Diffuse alopecia areata: This autoimmune disorder is the second most common type of non-cicatricial alopecia, causing hair loss from head to body.
Telogen effluvium: Hormonal changes or side effects of extreme physical and emotional stress can cause this type of hair loss. People can lose their hair very suddenly and witness a receding hairline.
Anagen effluvium: This type of hair loss occurs due to complex medical treatments such as chemotherapy, inflammation, etc.

What Are the Stages of Male Pattern Baldness?

According to the Norwood scale, which is used by doctors to classify hair loss, there are seven stages of male pattern baldness. These stages also highlight the symptoms of androgenic alopecia:

Stage 1: Baldness is completely absent at this stage. Your hairline can naturally be high or low; it would not indicate a recession of your hair.

Stage 2: There’s a slight 1 to 2 cm recession at the temples.

Stage 3: The hairline takes an “M” or “U” shape. Slowly, the frontal hairline retreats, or there’s a bald spot gradually appearing in the center of the skull.

Stage 4: There is a visible hairline on the temples, but the upper portion of the head loses almost all the hair.

Stage 5: Hairline recession continues except on the sides and the back.

Stage 6: Hair is completely recessed on the crown of the head and a cluster of hair is connected from the side to the back.

Stage 7: The top of the head shows a complete bald spot, sometimes only a thinning hairline from side to back of the head may remain.

What Are the Causes of Male Pattern Baldness?

If you are someone with male pattern baldness, you may be wondering: Why me? What is the cause? Unfortunately, some genetic and hormonal factors can exacerbate this condition in some people. Some simple and diagnosed reasons for this type of hair loss can include:

Genetic Tendency: Androgenetic alopecia has a strong genetic component that is conveyed into later generations. Because of the androgen dependency of the phenotype, the androgen receptor (AR) gene on the X-chromosome is considered a probable candidate gene for MPB.
Hormonal Changes: Hormones can play a vital role in the development of androgenic alopecia. The hair follicle shrinks due to dihydrotestosterone (DHT), which is converted from testosterone by the enzyme 5-alpha reductase.
Age: The prevalence of male pattern baldness (MPB) increases with age, primarily affecting older adults. Factors such as geography, environment, sociology, and health contribute to shifts in the age range of MPB occurrence.

How Do You Diagnose Male Pattern Baldness?

Male pattern baldness is relatively easy to identify; hence, dermatologists begin with basic queries such as medical history, family history, hormonal problems, stress, and anxiety issues. There are some tests which include:

Blood tests are used to diagnose medical conditions relating to hair loss, such as nutritional scarcity, thyroid diseases, etc.
Genetic testing and examination of DNA variations to see hereditary influences.
Scalp biopsy to identify any signs of infection or skin disease.

Proper lab analysis and examination are always necessary to recognize the root cause of the hair fall problem.

What Are the Treatment Options for Male Pattern Baldness?

There are various treatment options for androgenic alopecia. A systematic review assessed the efficacy of some possible treatments, such as:

Minoxidil: Topical or oral minoxidil can increase blood flow to the hair follicles. It is expected to stimulate hair follicles and promote hair growth. Recent research has also uncovered an anti-androgenic effect.
Finasteride: This medication is a type II 5α-reductase inhibitor, which means it blocks the conversion of testosterone to dihydrotestosterone (DHT). Finasteride, by preventing DHT synthesis, helps to reduce DHT levels in the scalp, which can halt the rate of hair loss and improve hair regeneration in MPB patients.
Platelet-rich plasma (PRP): Platelet-rich plasma can reduce hair loss by increasing the growth of dermal papilla cells. Moreover, it has anti-inflammatory properties for the scalp and increases blood flow in hair follicles.
Hair transplant: Hair transplants are by far the most effective method for male pattern baldness. It involves taking some hair from your donor area and transplanting them onto your balding area. You can get a very affordable hair transplant procedure in Turkey without breaking the bank. You can also opt to get a free consultation about your hair condition from renowned experts in this field.

The Bottom Line

Hair loss treatment can be a very demanding endeavour. Navigating the journey of male pattern baldness is never easy. It requires an understanding of the types and stages of hair loss.

First and foremost, you should give yourself time to recover and revive your hair. Among various medications, minoxidil stimulates hair growth, finasteride inhibits DHT synthesis. PRP promotes dermal papilla cell growth and increases blood flow but hair transplants are the most effective, long-term solution.

Along with medications and transplants, proper nurturing of hair, a balanced diet, a sufficient sleep cycle, a healthy lifestyle, good habits, and effective exercises can play an amazing role in defending the recession of bald spots or receding hairlines. This continuous routine can change your body clock and even your outward presentation without you even noticing! Remember, your dedication to a comprehensive routine can subtly transform not just your appearance but also your inner confidence, making the journey worthwhile.

The post From Hairline to Hair Loss: A Guide to Male Pattern Baldness appeared first on Cosmedica.

Ludwig Scale: A Means to Classify Female Pattern Baldness

Elisa Chistyukhina — Fri, 14 Apr 2023 19:49:11 +0000

The Ludwig scale is the conventional method of classifying female pattern hair loss, just as the Norwood scale is for classifying male pattern baldness. Similar to the Norwood scale, the Ludwig scale divides into stages, with any female hair loss patient fitting into one of them. This article will help you understand the Ludwig scale and assist you with the diagnosis and treatment of your androgenic alopecia.

What Is the Ludwig Scale?

The Ludwig scale is a scale hair loss specialists use to classify female pattern baldness, thereby determining how severe the condition is, as well as the most suitable treatment method. The scale was first proposed in 1977. Since its approval, it has gained widespread acceptance as the ideal method for measuring the progression of female hair loss.

Female androgenetic alopecia is the major cause of hair loss in women and is difficult to diagnose. This scale helps make it easier, so patients can know where they stand by comparing their symptoms to those described in the scale. The scale divides into stages, each representing a higher degree of hair loss than the previous one.

What Are the Different Stages of the Ludwig Scale?

Stage 1

Patients usually cannot detect stage 1 female hair loss because it doesn’t affect the hair’s overall thickness. At this stage, hair thinning occurs, but it’s mainly along the middle of the head where hair parting takes place. It doesn’t affect other parts of the head. Over time, stage 1 female alopecia becomes more obvious because the scalp starts to show whenever you part the hair.

Stage 2

By stage 2, when parting the hair, patients notice that the scalp becomes much more visible. They also observe pronounced thinning along the center. Whenever you part your hair, you will notice that the gap appears wide, alongside a decrease in the overall volume of hair on your head. At this stage, women are advised to go for a hair transplant to prevent the condition from worsening.

Stage 3

This is the final stage on the Ludwig. At this stage, the scalp is fully visible, and the top of the head may be completely bald. The density at the sides and back of the head may also reduce noticeably, as thinning is now widespread across the entire head. However, in many cases, the front hairline remains unaffected. Without intervention at this stage, a woman may be at risk of developing baldness.

How does the Ludwig Scale diagnose female pattern hair loss?

Female pattern hair loss progresses similarly for all women, and the Ludwig scale adequately describes this progression. To diagnose female pattern hair loss, you examine the scalp to see which stage of the Ludwig best describes your hair loss condition at that point in time. Over time, if the condition progresses from one stage to another, you can be sure you have female pattern hair loss.

However, for accuracy, it is better not to self-diagnose but rather to get a hair specialist to diagnose you. Plus, this way, you can get professional recommendations on a treatment method.

What Are the Treatments for Female Pattern Hair Loss?

The type of female pattern hair loss treatment you receive will largely depend on your stage on the Ludwig scale. Here are the top three treatments:

1. Medication

This type of treatment best suits stage 1 female hair loss patients and those experiencing early onset of stage 2. Here, the patient applies medication to the scalp to help the hair follicles grow thick and prevent more hair from falling.

Minoxidil is one of the most commonly used products for this purpose. However, results vary from person to person, and some individuals have reported side effects such as changes in hair color.

2. Platelet-Rich Plasma (PRP) Therapy

This treatment is another effective way to stop female pattern hair loss from progressing. In this method, healthcare professionals extract nutrient-rich plasma from the bloodstream and inject it directly into the hair follicles, promoting improved hair growth and strength.

3. Hair Transplant

This treatment provides the best result for any identified female hair loss patient, regardless of her stage on the Ludwig. However, it is advisable to opt for a hair transplant in Turkey at stage 2 when the donor sites are still full and thick.

The type of hair transplant method used will be determined by the surgeon, though most surgeons opt for the FUE hair transplant technique.

Frequently Asked Questions

What is the Ludwig Scale?

The Ludwig scale is a classification system used by specialists to determine the severity of female pattern baldness and guide treatment options. It categorizes female hair loss into stages based on its progression.

How does the Ludwig Scale diagnose female hair loss?

It helps in diagnosing female pattern hair loss by comparing the patient’s hair loss condition to the stages described in the scale. This aids in determining the progression of hair loss and the most appropriate treatment.

What do the stages in the Ludwig Scale mean, and how many are there?

The Ludwig scale has three stages. Stage 1 indicates minimal thinning that isn’t easily noticeable. Stage 2 shows a pronounced widening of the part and visible scalp. Stage 3 involves severe hair loss with a visible scalp and potential baldness at the top of the head.

When is it advisable to consider a hair transplant for female pattern hair loss?

A hair transplant is recommended at stage 2 of the Ludwig scale, where the hair thinning is significant, but donor sites are still full, offering the best results for the restoration process.

What is Grade 3 female pattern baldness?

Grade 3 on the Ludwig scale represents the most severe form of female pattern baldness, where the scalp is fully visible at the top of the head, and there may be complete baldness in this area. Thinning is widespread, though the front hairline might not be affected.

The post Ludwig Scale: A Means to Classify Female Pattern Baldness appeared first on Cosmedica.

Norwood Scale: Decoding the Stages of Male Pattern Baldness

Elisa Chistyukhina — Fri, 03 Feb 2023 13:02:00 +0000

Knowing about the Norwood scale is one thing that should concern all men, as every man will experience male pattern hair loss at some point in their life. Statistics have shown that more than half of all men experience significant hair loss by 50.

Although hair loss affects most men, the degree of hair loss varies from person to person. So, the Norwood scale was invented to adequately measure and classify male pattern hair loss into stages to determine the correct hair restoration treatment.

What is the Norwood Scale?

The Norwood scale is used to classify and diagnose the stages of male pattern baldness or androgenetic alopecia (the most common pattern of hair loss in men). Hair surgeons worldwide use this scale to diagnose the condition. The scale is easy to understand, and it adequately covers every stage of hair loss in men.

The Norwood scale is also called the Hamilton-Norwood scale. James Hamilton introduced the measurement scale in the 1950s.

In 1975, Dr O’Tar Norwood revised Hamilton’s classification after studying hair loss conditions in 1,000 patients. This study helped him develop a chart that could describe every stage of male pattern hair loss. The scale was first proposed for general use in 1975.

Today, hair restoration surgeons use the Hamilton-Norwood scale to determine the adequate number of grafts required for hair transplant surgery. The Norwood scale classifies male hair loss into 7 stages, each with its distinct hair loss zone and severity.

Norwood Stage 1-7

Stage 1

The first stage of the Norwood scale describes the typical adult male hairline with little or no balding. At this stage, there’s no visible hair loss around the crown or any other part of the head.

At most, the individual may notice slight shedding around the temples. This stage doesn’t require any treatments. At most, the individual gets a few tips or products to reduce shedding.

Stage 2

At this stage, the patient’s hairline recedes slightly at the temples, but there’s no visible thinning at the top of the head. Some describe stage 2 hair loss as a mature hairline.

Patients at this stage may have thinning hairs on either side of the head, and a hair transplant may not be necessary. Simple hair treatment products may suffice for this stage.

Stage 3

At this stage, the hairline recedes more dramatically, forming an M-shape at the temples. In some men, hair loss occurs at the crown of their heads (the vertex). In stage 3 vertex, men typically exhibit this pattern of hair loss.

Stage 3 marks the onset of balding, prompting a recommendation for hair transplant surgery at this stage. A hair surgery for stage 3 will require about 500 to 2,500 grafts, while stage 3 vertex will require 3,000 hair grafts.

Stage 4

Stage 4 hair loss is a more pronounced version of stage 3. At this stage of hair loss, men lose a substantial amount of hair at the temples and the crown.

Some men may only experience hairline recession at this stage, while their crown hair remains intact. For this stage, hair transplant surgery is recommended. It would typically require at least 3000 grafts.

Stage 5

Severe hair loss at the crown and temples characterizes this stage. The hair separating the 2 balding areas (top of the head and hairline) also becomes thinner.

Some men experience no hair loss from the crown, but the hairline recession surpasses that of stage 4. A hair transplant for this stage will require 4,000 grafts at least.

Stage 6

At this stage of hair loss, extreme balding occurs, and the band of hair separating the balding crown and the receding hairline almost disappears.

If there’s no balding at the top of the head, the patient’s hairline now recedes almost to the back of the head. At this stage, a hair transplant is inevitable and will require 5,000 grafts of hair or more.

Stage 7

This is the final and most advanced stage of hair loss, as described by the Norwood scale. At this stage, you have a band of hair around the back and sides of the head. Other parts of the head are already completely bald.

Patients at this stage may be too late for a hair transplant, though there have been a few cases of successful completely bald hair restoration surgeries.

Such treatment, however, will require a true professional so the remaining healthy hairs won’t get damaged or over-extracted. If sufficient body hair is present, one can also opt to have chest or beard hair transplanted to the head.

Can you go from Norwood Scale 2 to 1?

Usually, hair loss progresses from one stage to the other. However, if the hair loss was caused by other factors like lifestyle, habits, or stress, a positive change may reverse the effects, thereby restoring the receding hairline in stage 2 back to stage 1. Also, hair treatment products may help improve hair growth.

At what age do men start balding?

There’s no specific age for balding in men. It all comes down to genetics. For some men, it can be as early as their 20s or teenhood; for others, it may be in their 60s.

Typically, men lose hair as they get older. However, statistics show that 60% of men experience significant hair loss by 35 to 40 years, as this is when Dihydrotestosterone levels begin to decrease. And by age 50, 85% of men are already balding.

Do all men reach Norwood Scale 7?

No. The extent of your hair loss depends on your genetics and your DHT (Dihydrotestosterone) levels. Some men are extremely prone to getting bald and will reach level 7 despite hair loss treatments. Some other men will never reach level 7, even without hair treatment.

Normally, your hair loss pattern will start manifesting in your 30s. So, if you will have a Norwood 7, it will become evident by age 40. However, men are advised to undergo hair transplant surgery during the earlier stages of hair loss (Norwood stages 2-5) to prevent irreversible hair loss.

Why do some men not go bald?

Here are some of the reasons why some men do not get bald:

Genes: Genetics are the major factors that determine when a man’s baldness begins.
Low DHT levels: Too much DHT is extremely detrimental to the health of hair follicles.
Healthy lifestyle: No smoking, drinking or other addictions.
Good food that promotes the growth of healthy hairs
Stress-free lifestyle: Stress can cause hair thinning or hair loss in both men and women.

At what stage is a hair transplant not possible?

Hair transplants can be done at any stage. However, stage 7 patients are usually advised against getting a hair transplant, as there is usually just not enough donor hair to achieve satisfactory coverage.

However, there have been cases of successful hair restoration surgeries for Norwood stage 7 patients, mostly with the help of body hair. Therefore, a hair transplant in Turkey is possible at any stage; you just need to locate skilled hands and have sufficient body hair growth.

Frequently Asked Questions

What does the Norwood scale measure?

The Norwood scale categorizes male pattern baldness into stages, aiding diagnosis and treatment planning for hair loss. It provides a clear understanding of the progression and severity of hair loss.

Can hair loss reverse from Norwood 2 to 1?

In some cases, lifestyle changes or treatments may halt or reverse hair loss, potentially regressing from Norwood stage 2 to 1. However, results vary depending on individual factors.

When does male balding typically start?

Genetic predisposition often influences the onset of balding, causing variation in when it begins. While some experience it in their 20s or 30s, others may not notice significant hair loss until their 60s.

Do all men reach Norwood 7?

No, the progression to Norwood stage 7 varies based on genetics and DHT levels. Some may reach this advanced stage despite treatment, while others may not experience it at all.

When isn't a hair transplant feasible?

Health professionals generally discourage hair transplant at Norwood stage 7 due to limited donor hair. However, in some cases, successful transplants have utilized body hair.

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