Ludwig Scale Categorizes Stages of Female Pattern Baldness




If you have noticed considerable hair loss or thinning or a widening of your part line, you may be suffering from female pattern baldness. The Ludwig Scale can indicate the extent of your hair loss issues.

Signs of female pattern baldness

Female pattern baldness, sometimes referred to as androgenic or androgenetic alopecia, is characterized by general thinning of the hair on the top and crown of the head. It is usually first noticed by excessive hair fallout and/or a widening of the center hair part. Unlike hair loss in men, female pattern baldness rarely progresses to complete and total baldness. In women, most of the time the front hairline remains intact.

The Ludwig Scale for female pattern baldness

The Ludwig Scale allows women and their doctors to assess the appearance and pattern of hair loss. “Female pattern hair loss classically has a different appearance than male pattern hair loss,” explains Dr. Marc Avram, chief of dermatology at Downstate Long Island College Hospital in New York City. “Male pattern hair loss occurs with bitemporal recession and a bald area in the back/vertex of the scalp, with gradual thinning and eventual complete loss for some men. In contrast, female pattern hair loss always has an intact frontal hairline with no recession. In addition, there are no bald areas where there is no hair growing, but just a diffuse decrease in density of hair.”

The Ludwig Scale highlights three stages or classes of female pattern baldness.

In Stage 1, the hair begins to thin all over the scalp and you may notice that your part is getting wider. During this stage, a change in hairstyle, hair extensions and wigs can disguise hair loss. Some women also choose to use minoxidil to help regrow hair, as well as slow or stop hair loss. Research shows that minoxidil may grow hair in up to 25 percent of women. The treatment becomes expensive, however, because hair loss starts once again if you stop using the medication. Your doctor may also recommend B vitamins, iron supplements or dietary changes.

In Stage 2, the thinning at your part is now obvious. At this point, you probably have lost more than half of your hair. Now is the time to see a doctor, if you haven’t already. Your doctor will conduct a battery of tests to try to pinpoint the cause of your hair loss and to eliminate certain disorders.

“If a woman starts experiencing major hair loss, she should have her thyroid levels checked and have blood work done,” explains Dr. Sean Behnam of Dermatology & Hair Restoration Specialists in Santa Monica, Calif. “Female pattern baldness and hair loss in women can be attributed to a number of factors, including hormones and genetics, or can be associated with various medical conditions. Hair loss can stem from various issues that females are prone to such as anemia and hypothyroidism, and it can affect women who have recently given birth. Other causes may include crash dieting, significant emotional illness (such as post-traumatic stress disorder) and general stress. However, stress-related hair loss tends to be temporary, and usually the hair will grow back within six months.”

At Stage 3 of the Ludwig Scale, you can easily see through to your scalp with nearly 70 percent of your hair thinned out. Consider wearing a wig or consulting a hair transplant surgeon to see if you are a suitable candidate for a procedure. Some women with female pattern baldness are not viable candidates for hair transplants because of the reduction of ample donor hair and overall, diffuse thinning of the hair.

How to disguise female pattern baldness

A number of methods are used to help disguise female pattern baldness. Dr. Behnam explains some of the common options.

“One popular approach is hair loss concealers, a cosmetic product designed to hide bald spots and thicken thinning hair. They are essentially a powder made of magnetized fibers that cling to hair, look natural and won’t fall out easily. A medication such as Rogaine [minoxidil] is extremely popular, but it works only if used constantly, and many of my patients tire of having to apply it so often. There is also an at-home low-level laser therapy product called HairMax Laser Comb (it is FDA approved). It helps hair grow by stimulating the hair follicle.”

By looking in the mirror and comparing your own hair against the Ludwig Scale examples, you can determine whether you are experiencing typical female pattern baldness. If you are concerned, visit a medical doctor or dermatologist to try to ascertain the cause and extent of your condition. Fortunately, hairpieces and wigs, as well as various other options, are available to help hide female pattern baldness.