iAremyhair believes in giving our customers ample information so that they can make wise decisions regarding hair loss treatment.
For this purpose, we will be introducing a series of topics that offer insight and objective viewpoints. Topics range from basics of hair to hair loss causes to treatment options to other related and interesting issues.
To ensure that our readers get the most out of our newsletters, we have condensed information from established publications and online reference materials such that each topic can be easily digested. iAremyhair invites you on this journey and welcomes your comments.
Pattern thinning refers to a type of hair loss that occurs gradually over time. Both men and women experience pattern thinning but the experience is different for each gender.
Norwood Classification System
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Origin Dr. O'Tar Norwood devised thisclassification system in the 1970s, answering the all-important question, "How bald am I?" |
A man who comes from a family with bald members is more likely to be on the lookout for baldness symptoms but he may not be balding. Genetics can play tricks on men - a man with a full head of hair may, on the other hand, see extensive balding in his family line. In any case, treatment can be very successful if evidence of pattern thinning is detected early. Scalp mapping through the use of video microscope allows the doctor to measure male pattern thinning by degrees using the Norwood classification system which provides two systems :
Regular Male Pattern Thinning
Hair loss is divided into seven patterns.
Hair loss may progress from one pattern to the
next, or it may develop any one of these patterns
all at once.
The majority of men with pattern thinning follow
the regular pattern, with hair loss starting in the
front and progressing slowly in two different areas
(Class IV and V).
Over time, the frontal and crown areas enlarge
and merge, and the entire front, top, and crown
of the head may become bald (Class VI or VII).
Baldness in some men progresses such that they fall somewhere between the different stages;
in others, hair loss comes to a halt and they remain in one stage without progressing to the
next. The general consensus is that advanced balding (defined as a Norwood Class V,VI or VII
pattern) occurs in about 35% of balding men.
Type A Pattern Thinning
Less common than the regular pattern and it occurs in 10 percent of men.
Hair loss progresses from the front to the back, possibly reaching the
crown of the head and stopping about where the swirl exists.
Type A pattern thinning is most dramatic in front and thus Type A men
tend to look quite bald even though their hair loss is minimal.
Ludwig Classification System
The cause of female hair loss is usually reflected in the pattern and so doctors look to the pattern of loss to get an idea of the cause and how to treat it.
About 10% of women experience the classic pattern of genetic hair loss. There are many patterns of genetic hair loss : * Intact frontal hairline for the first 2/3 inch or so and hair loss behind that persistent hairline * Hair loss confined to the top of the head, sparing the leading frontal edge of the hair line * Diffuse hair loss, which is a thinning of the hair all over the head and isn't confined to any particular area. This is more common in postmenopausal women but it does show up in younger women as well.
For women with perimenopause[1], pattern thinning is usually worse in the front of the thinning, about 2 to 3 inches behind the hairline. Thinning tends to be diagnosed in the 30s or 40s. It is present but less frequent with women in the 20s. The good news : once thinning is recognised in these women, it is generally stable over time and does not show the progressive nature of the male balding patterns, at least until they reach menopause.
However, genetic hair loss is relatively uncommon in women and is generally referred to as female pattern hair loss. Its common pattern differs from that of men. The postmenopausal pattern in women is characterized by diffuse thinning starting just behind a normal hairline and extending to and beyond the swirl. Unlike men, adult women with typical female postmenopausal androgenetic alopecia often have significant hair loss in the back and side of the scalp.
Compared to men, the mechanism of balding in women is less well understood because hair loss isn't as directly related to the presence of DHT. The enzyme aromatase appears to have a role in causing female hair loss and may partially explain the different pattern when compared to men. The changes in hormones that occur around menopause are an obvious contributing factor.
A different classification system is used for hair loss pattern in women. A Ludwig type I : a mild widening of the part width. Type II : increased thinning with moderate widening of the part. Type III : significant widening of the part width.
A minority of women develop pattern balding in a distribution that's similar to men and thus these patients are better classified using the Norwood classification system.
Female hair loss can stem from a variety of medical causes and thus it is recommended that women undergo a thorough medical examination to determine the cause.
[1] perimenopause: The time in a woman's life when physiological changes occur that begin the transition to menopause.
Reference Materials
Rassman, William R, M.D. and Bernstein, Robert M, M.D. "Hair Loss & Replacement for Dummies" USA : Wiley Publishing, Inc, 2009.
