Hair Loss in Women Archives - 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.

Hair Loss During the Menopause

Elisa Chistyukhina — Wed, 20 Oct 2021 08:44:00 +0000

Many women experience hair loss during the menopause. Oestrogen levels drop sharply, increasing the risk of the hair thinning out and bald spots appearing.

The first thing to say is that losing hair is a completely normal physical process. Even a person with full hair growth loses up to 100 hairs a day. However, it becomes an issue when the hair that has fallen out suddenly stops growing back. This is when bald patches start appearing or hair starts to thin out.

Genetically induced hair loss is not a male-only affair. Some women suffer from it too. However, this is usually a little later in life compared to men, namely with the onset of menopause.

Many women affected by menopausal hair loss suffer enormously from it, because particularly for women, full and healthy hair is a beauty ideal. This is not least because thick and beautiful hair also stands for attractiveness and youthfulness.

Female hair loss therefore often means that women experience an associated loss of self-esteem.

What happens during menopause?

The menopause is when women stop having periods. For most women, menopause begins between their mid-40s and mid-50s, although this should not be generalized. In the UK, the average age for the menopause is 51.

During this period, oestrogen and progesterone production gradually decreases. Menstrual periods become more irregular until they eventually stop.

The menopause affects many aspects of women’s lives. Very typical symptoms of menopause are the famous hot flashes, mood swings, thickening facial hair, and troubles getting to sleep.

These hormone fluctuations also affect the hair. Hair becomes thinner, and hormone-induced hair loss is not uncommon in menopausal women. The male hormone testosterone plays a major role in this.

Hereditary hair loss during the menopause

Just as in men, the hair roots of women suffering from hereditary hair loss are sensitive to the androgen DHT, which in turn is formed from the male hormone testosterone.

Before the menopause, however, oestrogen keeps the male hormone testosterone in check. The production of this hormone, however, as already mentioned, steadily decreases during menopause. Therefore, its ability to counteract the effects of testosterone and DHT reduce.

The DHT ensures that the growth phase of the hair is shortened in the hair follicles which are oversensitive to it. As a result, the hair grows back thinner overall, until at some point only a very thin fuzz remains, which is virtually invisible to the human eye.

Symptoms of hereditary hair loss during the menopause

Unlike men, women affected by female pattern hair loss are usually not at risk of complete baldness.

However, hair starts to fall out along the crown of the head. The process is gradual. Initially, the hair in this region becomes thinner until eventually the scalp shows through the remaining hairs.

The causes have not yet been conclusively clarified. It is suspected that several other factors can come together in addition to the genetic aspect of the hair loss.

These can be, for example:

• PCOS (polycystic ovary syndrome)
• Abuse of anabolic steroids, or the side effects from certain medications
• Androgenital syndrome (a hormonal imbalance in the adrenal cortex)

Treatment options for hair loss during menopause

As a women affected by the menopause, you should not be afraid to go to the doctor if you suspect that you are suffering from hereditary hair loss. The doctor can, for example, perform a trichogram to determine the status of the hair roots.

There are some medicinal products which may help. For example, minoxidil can be applied directly to the scalp. It stimulates the scalp and ensures good blood circulation to the scalp. This is essential for healthy hair growth, and the use of this drug may help matters.

Some women also opt for hormone replacement therapy (HRT). This helps alleviate many of the negative symptoms of the menopause. It can sometimes help with menopausal hair loss.

There are also nutritional products that have been specially adapted to the needs of women. Many women find that they can also do a lot from the inside to stimulate hair growth again. A balanced diet helps to maintain the splendour of the hair. Particularly helpful are protein and iron-rich foods. Also, vitamin B is important to full hair growth.

A permanent solution: a hair transplant

If hereditary hair loss is already advanced, or you are suffering psychologically because of your hair loss, a hair transplant can provide relief.

In this minimally invasive procedure, an experienced surgeon removes hair follicles from the donor area between the ears at the back of the head. They are then reinserted into the recipient area to fill in the bald spots. What is special about the hair from this donor area is that it is relatively insensitive to the hormone DHT.

Dr. Acar and our team at Cosmedica Clinic offer years of experience in such matters. We offer a free consultation to make sure that a transplant is the correct treatment for you.

We will be happy to answer any questions you may have about hair transplantation for women.

The post Hair Loss During the Menopause appeared first on Cosmedica.

Hair Loss During Pregnancy – Is This Normal?

Cosmedica — Wed, 28 Jul 2021 12:50:00 +0000

For most women, hair grows thicker and shinier during pregnancy. However, the reverse can also be the case. Severe hair loss during pregnancy is also relatively frequent and usually nothing to worry about.

Pregnancy involves big changes for a woman’s body. The body releases more hormones, especially estrogen, known as the “women’s hormone.”

Usually, the result of more oestrogen is that the hair grows more fully and appears more beautiful and healthier overall. This is because fewer hair follicles than usual enter the telogen phase, or resting phase.

After the birth of the baby, the levels of oestrogen in the body then return to normal and many of the extra hairs fall out at the same time. Many women experience this type of hair shedding, known as postpartum hair loss.

However, the opposite can also occur to the hair during pregnancy. A few women experience hair loss. Too many hair follicles enter the resting phase at once, a condition known as telogen effluvium.

Hormones are not always to blame for this. There can be other factors at play which causes the hair to fall out.

Reasons for hair loss during pregnancy

Hormones

Severe hair loss during pregnancy is rare but is not in itself a major cause for concern.

The hormone progesterone, produced by the corpus luteum, is suspected of being a factor in increased hair shedding. This hormone works together with oestrogen to regulate pregnancy.

This interaction can have an influence on hair growth and quality, both positively and negatively. For example, dry hair can become even drier and break more easily.

In addition, it may be that hair synchronises its growth phases due to the influence of the hormones. In this way, too many hairs enter the resting phase together and therefore fall out at the same time.

Contraceptive pill

A second factor that can lead to hair loss during pregnancy is ceasing to take the contraceptive pill. Women who have stopped taking the pill and then become pregnant relatively quickly often have to deal with hair loss.

One of the reasons for this is that the pill artificially keeps oestrogen levels high. If pregnancy then occurs, the oestrogen level in the blood is then usually not as high as it was when the pill was still being taken.

The hair can therefore fall out because, as we have already discussed, this hormone has a positive effect on the growth cycle.

Iron deficiency

Another cause of hair loss during pregnancy can be iron deficiency. During pregnancy, the growing child utilizes so much iron that the body requires up to 60 percent more of it. However, if insufficient amounts of this mineral are supplied, the body halts all non-essential functions that rely on iron but are not vital for survival.

This includes hair growth. Other symptoms that can indicate iron deficiency in the blood are pale skin, constant tiredness and – under certain circumstances – increased nervousness.

If you suspect you have a iron deficiency, you should consult a doctor immediately. The most common time for women to experience an iron deficiency is in the second trimester of pregnancy.

Another thing that can lead to hair loss during pregnancy is stress. Many expectant mothers put themselves under pressure during their pregnancy, especially when it is their first child.

This can have a negative effect on hair growth. Prolonged stress can cause diffuse hair loss even if there is no pregnancy.

Hair care during pregnancy

Finally, daily hair care also has an influence on hair growth. Normally, pregnant women do not have to change their daily hair care routine much, such as which shampoos and conditioners they use.

However, this does not apply to dyeing the hair. To this day, this topic is hotly debated. Even today, there is no scientific evidence that hair dyeing during pregnancy has a harmful effect on the foetus. In general, however, doctors advise against it.

However, if you do not want to give it up, you should at least use natural hair dyes during early pregnancy.

As a rule, hair growth should return to normal after pregnancy and the hair that has fallen out should grow back.

However, if it does not, this may be because the increased hair loss has revealed an already-existing type of hair loss such as female pattern baldness or alopecia areata. It may also have made other underlying hair health issues more apparent.

In which case, a hair transplant can be the solution to restore the splendour of your old hair. However, no reputable hair doctor will do a hair transplant without first fully exploring the causes of hair loss.

Dr Acar and his team are happy to answer any questions you may have on this topic. Take advantage of a free, no commitment, consultation today.

FAQ

Is hair loss during pregnancy normal?

Yes, for some women, experiencing hair loss during pregnancy is normal. It’s often attributed to hormonal changes and usually resolves after childbirth.

What are the reasons for hair loss during pregnancy?

Several factors can contribute, including hormonal fluctuations, ceasing contraceptive pills, iron deficiency, stress, and existing hair health issues.

How do hormones affect hair loss during pregnancy?

Hormones like progesterone and estrogen play a significant role. Their interaction can influence hair growth phases, potentially leading to increased shedding.

Can iron deficiency cause hair loss during pregnancy?

Yes, iron deficiency is a common cause of hair loss during pregnancy. The body’s increased demand for iron during pregnancy can lead to hair loss if not enough of this mineral is available.

What precautions should be taken for hair care during pregnancy?

While daily hair care routines usually remain unchanged, avoiding hair dyeing, especially during early pregnancy, is advised. Hair growth typically returns to normal postpartum, but persistent issues may require medical attention.

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Hair Loss in Women: The Causes and the Solutions

Elisa Chistyukhina — Wed, 02 Jun 2021 09:43:17 +0000

Hair loss in women can be caused by hormones, autoimmune diseases, or genetic predisposition.

It is normal for about 100 hairs to fall out every day. But if there are suddenly more than this, then we are dealing with a hair loss situation.

Gender makes little difference to hair loss: it affects both women and men. According to statistics, about 80% of men and about 40% of women in the UK suffer from genetic hair loss, androgenetic alopecia.

However, hereditary hair loss is not always to blame for a sudden increase in hair shedding.

There are many other possible types of hair loss seen in women. For example, an autoimmune medical condition or persistent stress can cause the hair to become thinner and thinner.

Thinning hair in women

If the hair falls out evenly across the scalp, it is called diffuse hair loss. The causes for this are manifold and are usually to be found in your external life circumstances.

Diffuse effluvium can be caused by permanent stress or lack of sleep, or also by malnutrition. Other causes of hair loss include:

A side effect of medication
Hormone fluctuations (especially in pregnancy)
A poor diet (especially iron deficiency or zinc deficiency)
Smoking

Diffuse hair loss can be treated relatively effectively if the trigger that is making you lose hair is identified. As a rule, as soon as the trigger for hair loss has disappeared, the hair starts to grow again. If the hair has fallen out during a mono diet, for example, a sensible change in nutrition can have quick and positive results.

Hair loss after pregnancy

Hair loss after pregnancy is natural and affects almost every woman. As soon as hormone levels have stabilised again, hair stops falling out.

Hair follicles go through cycles of growth phase and resting phrase. When they switch the to resting phase, the hair falls out, but this is not noticeable as other hairs are still in the growth phase.

During pregnancy, oestrogen and HCG (Human chorionic gonadotropin) levels are greatly increased. This prevents hair from falling out naturally. That is why pregnant women have fuller hair than usual.

Let’s assume that a pregnancy usually lasts around 40 weeks. That is 280 days, during each of which 100 hairs should fall out.

But just half of them fall out because of the high oestrogen level. That is 14,000 hairs that have not fallen out.

These 14,000 additional hairs then do fall out after pregnancy. Therefore, it looks as if you have severe hair loss.

Hair loss after stopping the pill

Discontinuation of the contraceptive pill can also be a cause of hormonally induced hair loss.

The pill interferes with a woman’s hormone balance to prevent a fertilised egg from implanting in the uterus.

Ovulation is switched off. The oestrogen level remains artificially high thanks to the pill, and hair falls out less, the same as in pregnancy. After stopping the pill, the oestrogen level drops. At this point the hair falls out again.

Another reason for increased hair loss after stopping the pill can be that the ovaries suddenly produce more male hormones. This can have a negative effect on hair growth, especially if the woman already has a predisposition to androgenetic alopecia.

Another consequence can be acne and blemished skin.

Furthermore, nutrient deficiencies can cause hair loss. This is because the liver, intestines and thyroid gland must first recover. Taking the pill can also have an effect on these organs.

Alopecia Areata - circular bald spot

To date, the exact causes of circular hair loss have not been clarified. In this autoimmune disease, the patient’s own immune system identifies the hair roots as foreign bodies and attacks them accordingly.

As a result, bald circular patches occur, which can be spread over the head.

There are four types of alopecia:

Alopecia Ophiasis – hair falls out like a wreath in the neck and ear area.
Alopecia Areata – circular hair loss.
Alopecia Totalis – the entire head hair falls out.
Alopecia Universalis – the entire body hair falls out.

Alopecia areata often occurs in connection with other diseases, for example with white spot disease (vitiligo).

In addition, some people are simply predisposed to alopecia. The disease can occur in episodes, so that those affected can be free of symptoms for a long time, but then the hair suddenly falls out again.

Androgenetic alopecia in women - hair loss during the menopause

Genetic hair loss is what doctors call androgenic alopecia.

Not only men are affected by hormonal and hereditary pattern of hair loss. Women can also suffer from it, only female pattern baldness usually starts much later compared to male pattern baldness. Usually it starts with the onset of the menopause.

As the name suggests, hereditary female pattern hair loss is genetically determined.

Just like in men, the hair roots react sensitively to the androgen dihydrotestosterone (DHT).

This has its origin in the male hormone testosterone.

Until the onset of the menopause, oestrogen keeps this hormone in check.

When the menopause begins, the production of oestrogen decreases, and the hour of testosterone has come.

Unlike in men, hereditary hair loss in women begins along the crown of the head. This area thins out more and more until at some point the scalp shows through.

What to do about hair loss?

Women often suffer badly from the loss of their hair – much more than men.

Even today, beautiful and healthy hair is still considered the female ideal of beauty. Many women look online or among their friends for a support group.

As we said before, the rule with diffuse hair loss is that the hair grows back as soon as the trigger for it has disappeared.

What can I do, however, if my hair doesn’t grow back or I am suffering from hereditary hair loss?

A hair transplant can be a remedy for this, as it is carried out at Cosmedica Clinic, for example. Especially in the case of hereditary hair loss, a hair transplant is a long term and permanent solution.

Only in the case of alopecia areata is such an intervention not possible, as the immune system would immediately attack the freshly transplanted follicles again.

Get a free, no commitment consultation with Dr. Acar at Cosmedica Clinic to discuss your hair loss and see what he can do for you.

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