The stages of hair loss
Even without a precise diagnosis of hair loss, a general examination can show how advanced hair loss is. In order to have an objective view, hair condition is categorised using various scales. For men, the Hamilton Norwood scale is often used, and the Ludwig scale is used for women.
The Hamilton Norwood scale is a scale for the different stages of androgenic hair loss mainly in men. It was developed by Hamilton in 1951 and modified by Norwood in 1975. The scale has seven stages of baldness, which covers around 80 percent of androgenic hair loss cases. The classification of the individual phases of hair loss according to Hamilton/Norwood allows a standardised documentation of hair loss.
The stages of the Hamilton-Norwood scale:
Stage I: No or very slight receding hairline.
Stage II: Hair loss on the front and towards the back of the head. Formation of bald spots on the temples, no further than a two centimetre imaginary connecting line in front of the exterior ear canals.
Stage III: The receding hairline goes beyond the imaginary connecting line in front of the ear canals towards the back of the head. Minimum level for alopecia.
Stage IV: Hair loss areas have merged in the brow and crown area, hairless areas expanding towards the sides.
Stage V: Zone of distinct hair loss on the front and sides are only separated by a narrow hair zone, the hair on the temples and on the back of the head takes a “horseshoe” shape (also type VI and VII)
Stage VI: Hair loss areas have merged in the brow and crown area, hairless areas expanding towards the sides.
Stage VII: Only a narrow band of the original hair remains, which goes from the ears around the back of the head.
An alternative classification system was based on the Hamilton-Norwood scale and was published by Ludwig in 1977. As it describes more diffuse hair loss spreading from the apex over the head, the scale is more suitable for hair loss in women. But it can be used for men whose hair loss proceeds in this way (one fifth of men affected by hair loss).
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