Dermatologist’s View About Ludwig Pattern Hair Loss

Gradual thinning of scalp hair, often over several years, is the usual presentation of this type of hair loss in females. Unlike telogen effluvium (TE), a history of excessive hair shedding is usually absent at onset. 

Enrick Ludwig rendered a comprehensive classification depending on the progression of hair loss.  Ludwig′s classification recognises three patterns representing stages or progression of female pattern baldness.

According to dermatologists, the Ludwig Pattern hair loss scale illustrates progressive hair loss patterns in women and can help determine your level of hair loss. It is useful for purposes of diagnosis and discussion and can help doctors determine the next course of action.

Stage I 

This is characterised by a perceptible thinning of hair from the anterior part of the crown with minimal widening (rarefaction) of the part width. The hair loss at this stage can easily be camouflaged. This type may manifest in young women with SAHA syndrome (seborrhea, acne, hirsutism, and alopecia) and is generally associated with underlying hormonal imbalances.

Stage II 

This is seen with advancing age when the rarefaction on the crown becomes more pronounced, and the number of thinner and shorter hairs increases. Camouflage of the denuded areas by special hairstyles is no longer possible. Decreased hair density over frontal (frontal accentuation) and vertex regions is often seen. 

Stage III 

This is usually not encountered before menopause, and the crown may become bald. Contrary to what happens in men, a fringe of hair along the frontal hairline persists. 

Most of the time, female pattern baldness will not progress to complete baldness like men, but the diffuse thinning and loss of density can be equally distressing. Getting your hair loss checked for proper diagnosis and ruling out all possible causes is always a good idea.