Picture showing the different stages of the Ludwig scale

Ludwig Scale: A Means to Classify Female Pattern Baldness

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The Ludwig scale is the conventional method of classifying female pattern hair loss, just as the Norwood scale is for classifying male pattern baldness. Like the Norwood scale, the Ludwig is divided into stages, and any female hair loss patient will fit into one of them. This article will help you understand the Ludwig scale and assist you with the diagnosis and treatment of your androgenic alopecia.

What Is the Ludwig Scale?

The Ludwig scale is a scale hair loss specialists use to classify female pattern baldness, thereby determining how severe the condition is, as well as the most suitable treatment method. The scale was first proposed in 1977. Ever since it was approved, it has become widely accepted as the ideal way to measure how female hair loss progresses.

Female androgenetic alopecia is the major cause of hair loss in women and is difficult to diagnose. This scale helps make it easier, so patients can know where they stand by comparing their symptoms to those described in the scale. The scale is divided into stages, with each subsequent stage depicting a higher degree of hair loss.

What Are the Different Stages of the Ludwig Scale?

The Ludwig is divided into three stages as follows:

Stage 1

Patients usually cannot detect stage 1 female hair loss because it doesn’t affect the hair’s overall thickness. At this stage, hair thinning occurs, but it’s mainly along the middle of the head where hair parting takes place. It doesn’t affect other parts of the head. Over time, stage 1 female alopecia becomes more obvious because the scalp starts to show whenever you part the hair.

Stage 2

By stage 2, the scalp is much more visible after parting the hair, and the thinning along the center is also very pronounced. Whenever you part your hair, you will notice that the gap appears very wide, alongside a notable decrease in the overall volume of hair on your head. At this stage, women are advised to go for a hair transplant to prevent the condition from worsening.

Stage 3

This is the final stage on the Ludwig. At this stage, the scalp is fully visible, and the top of the head may be completely bald. The density at the sides and back of the head may also reduce noticeably, as thinning is now widespread across the entire head. However, most times, the front hairline may not be affected. If something isn’t done at this stage, a woman may be at risk of growing bald.

How Is the Ludwig Scale Used to Diagnose Female Pattern Hair Loss?

Female pattern hair loss progresses similarly for all women, and the Ludwig scale adequately describes this progression. To diagnose female pattern hair loss, you examine the scalp to see which stage of the Ludwig best describes your hair loss condition at that point in time. Over time, if the condition progresses from one stage to another, you can be sure you have female pattern hair loss.

However, for accuracy, it is better not to self-diagnose but rather to get a hair specialist to diagnose you. Plus, this way, you can get professional recommendations on a treatment method.

What Are the Treatments for Female Pattern Hair Loss?

The type of female pattern hair loss treatment you receive will largely depend on your stage on the Ludwig scale. Here are the top three treatments:

1. Medication

This type of treatment is best suited for stage 1 female hair loss patients and early onset of stage 2. Here, the patient applies medication to the scalp to help the hair follicles grow thick and prevent more hair from falling.

One of the most commonly used products for this purpose is Minoxidil. However, results vary from person to person, and a few side effects have been reported, like hair colour changes.

2. Platelet-Rich Plasma (PRP) Therapy

This treatment is another effective way to stop female pattern hair loss from progressing. In this method, nutrient-rich plasma is drawn from the blood and injected into the hair follicles to facilitate and improve hair growth and strength.

3. Hair Transplant

This treatment provides the best result for any identified female hair loss patient, regardless of her stage on the Ludwig. However, it is advisable to opt for a hair transplant in Turkey at stage 2 when the donor sites are still full and thick.

The type of hair transplant method used will be determined by the surgeon, though most surgeons opt for the FUE hair transplant technique.

FAQ – Ludwig Scale

No. Just as you cannot stop a hair follicle on your head from growing, you also can’t completely stop your hair from falling off. Treatments like minoxidil will only minimize hair loss, and a hair transplant will restore some lost hair. But overall, you can’t stop female pattern hair loss.

It varies. For most women, it begins at midlife; for others, it may start earlier. Generally, women between the ages of 40 and 60 experience female pattern hair loss. However, genetics and lifestyle are the two major factors that determine how soon your hair loss will begin.

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