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Hair Loss Classifications
Hair loss happens in typical patterns while less common types have also been
identified. These patterns are classified into different types, most commonly via the
Norwood Classification for males and Ludwig Classification for females.
Before diving into the different classes, it’s helpful to know the regions of the scalp:
Hair Loss in Men: The Norwood Classification System
Male-pattern baldness occurs in men whose hair follicles, usually on the top and
front of the head, are sensitive to the hormone DHT. The susceptible hairs in these
areas become weaker, finer and eventually stop growing. Hair on the sides of the
head are resistant to DHT, and even men with advanced baldness may have a lifetime
of healthy hair follicles on the sides of the head.
Dr. O’tar Norwood published the Norwood classification for hair loss, which defines
two major patterns and less common types in the Norwood Classification and the
Type A Norwood Variant, respectively.
Norwood Classification
Type A Norwood Variant
Norwood identified variants of Types II through V, labeling them as Type A variant.
With these types, frontal recession keeps advancing backwards in one single area of
balding. In other words, there is no simultaneous balding of the vertex. The full
extent of balding tends to be more limited in comparison with the Regular classes.
Scattered sparse hairs can be observed in the entire area of balding.
These variants only exist in about 3 percent of hair loss population studies.
Hair Loss in Women: The Ludwig Classification system
DHT, which affects hair follicles, is counteracted by estrogen. For women, hair loss
usually begins at menopause when estrogen levels begin to drop, and then, women’s
hair may become prone to the effects of DHT. But unlike male patterned baldness,
hair loss for women is marked by thinning throughout the scalp, while full bald spots
at the crown are rare.
Hair loss for women can be classified into:
The most common is diffuse, non-scarring hair loss, which is hereditary. This type
has its own classification called the Ludwig classification. In this pattern, the frontal
hairline is typically and relatively preserved. Meanwhile, there is hair loss on the
front and top of the scalp, which can be classified into 3 types:
A hair restoration doctor can help you determine the pattern of your individual hair
loss pattern. Contact us today to schedule a free consultation with Dr. Gabel.
identified. These patterns are classified into different types, most commonly via the
Norwood Classification for males and Ludwig Classification for females.
Before diving into the different classes, it’s helpful to know the regions of the scalp:
Vertex: the top of the scalp toward the back
Frontal: the top, front part of the scalp
Temporal: the areas to the left and right of the
frontal region of the scalp
Parietal: the top of the back of the scalp or the area
directly beneath the vertex
Occipital: the region above the neck and below the
parietal region
Hair Loss in Men: The Norwood Classification System
Male-pattern baldness occurs in men whose hair follicles, usually on the top and
front of the head, are sensitive to the hormone DHT. The susceptible hairs in these
areas become weaker, finer and eventually stop growing. Hair on the sides of the
head are resistant to DHT, and even men with advanced baldness may have a lifetime
of healthy hair follicles on the sides of the head.
Dr. O’tar Norwood published the Norwood classification for hair loss, which defines
two major patterns and less common types in the Norwood Classification and the
Type A Norwood Variant, respectively.
Norwood Classification
- Type II
Indicates a progression to the mature hairline that sits no more than
2cm above the upper brow crease, with some temporal recession. This
does not represent balding.
Type III
The earliest stage of male hair loss, Class III is the minimal level
considered to represent baldness, characterized by a deepening
temporal recession.
Type III Vertex
Early hair loss in the crown, or vertex, is mostly seen with advancing
age. Frontal hair loss may be similar to Types I or II, but should not
exceed Type III.
Type IV
Further frontal hair loss as well as the vertex is more severe than Type
III, but there is still a distinct band of hair separating the front and
vertex across the top.
Type V
The bridge of hair separating the bald areas in the front and crown
begins to break down. The hair left on the occipital and parietal areas
begins to form into a horseshoe shape.
Type VI
The horseshoe shape of Type V is also true for this classification of
which the frontal and vertex areas of hair loss are contiguous, forming a
single large bald area on the front and top of the scalp.
Type VII
The most severe form of male pattern baldness, only a narrow
horseshoe-shaped band formed by the hair located on the back and
sides of the scalp remains.
Type A Norwood Variant
Norwood identified variants of Types II through V, labeling them as Type A variant.
With these types, frontal recession keeps advancing backwards in one single area of
balding. In other words, there is no simultaneous balding of the vertex. The full
extent of balding tends to be more limited in comparison with the Regular classes.
Scattered sparse hairs can be observed in the entire area of balding.
These variants only exist in about 3 percent of hair loss population studies.
- Type IIa
Entire frontal hairline is beginning to recede in unison without leaving
the mid-frontal peninsula of hair.
Type IIIa
Frontal hairline continues to recede toward mid-coronal line.
Type IVa
Hairline recession exceeds past the mid-coronal line.
Type Va
Hairline recession extends towards the vertex with back part of bald
area narrower than in regular Norwood VI.
Hair Loss in Women: The Ludwig Classification system
DHT, which affects hair follicles, is counteracted by estrogen. For women, hair loss
usually begins at menopause when estrogen levels begin to drop, and then, women’s
hair may become prone to the effects of DHT. But unlike male patterned baldness,
hair loss for women is marked by thinning throughout the scalp, while full bald spots
at the crown are rare.
Hair loss for women can be classified into:
- Diffuse hair loss
- Localized hair loss
- Patterned hair loss
The most common is diffuse, non-scarring hair loss, which is hereditary. This type
has its own classification called the Ludwig classification. In this pattern, the frontal
hairline is typically and relatively preserved. Meanwhile, there is hair loss on the
front and top of the scalp, which can be classified into 3 types:
Type I (mild)
In this stage, hair loss is minimal with early thinning that can be easily
camouflaged with careful grooming.
Type II (moderate)
Volume of hair is noticeably decreased, while the mid-line part is wider.
Type III (moderate)
Generalized thinning with a see-through look on the top of the scalp is
typical.
A hair restoration doctor can help you determine the pattern of your individual hair
loss pattern. Contact us today to schedule a free consultation with Dr. Gabel.
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