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Decoding Hair Loss

Decoding hairloss

Understanding the Language and Criteria Experts Use to Recommend Treatment for Men and Women

In order to start a conversation about hair loss it’s important to understand how it is measured, what constitutes normal versus excessive hair loss, and the current statistics surrounding this issue.

Decoding hairloss

Understanding Hair Growth and Loss

Normal Hair Cycle

– Anagen Phase: Active hair growth lasting 2-7 years.

– Catagen Phase: Transitional phase lasting about 2-3 weeks.

– Telogen Phase: Resting phase, hair falls out, lasting about 3 months.

Average Hair Loss

– On average, a person loses between 50 to 100 hairs a day. This is considered normal as part of the hair renewal process.

 Measuring Hair Loss

Tools and Techniques

  1. Daily Hair Count: Collecting hair lost in a day to measure against the average range.
  2. Pull Test: Gently pulling on a cluster of hairs to see how many come out. Typically, less than three hairs per pull is normal.
  3. Scalp Biopsy: Analyzing a small section of scalp skin under a microscope.
  4. Phototrichograms: A photographic analysis to assess hair density and growth.
  5. Hair Weight Tests: Weighing collected hair to quantify loss.

Scalp and Hair Analysis Tools

  • Trichoscopy: Dermatoscopic examination of hair and scalp.
  • Computerized Hair Analysis: Software used to measure hair density and diameter.

 Statistics of Hair Loss

# Gender-Specific Data

Men: By the age of 50, approximately 50% of men experience noticeable hair loss due to male pattern baldness.

Women: Around 40% of women experience hair thinning by the age of 50, often linked to hormonal changes.

Age-Related Statistics

The incidence of hair loss increases with age. By the age of 60, a significant number of individuals exhibit some degree of thinning.

 Causes and Prevalence

  • Genetic Factors: The primary cause in 80% of cases.
  • Medical Conditions: Thyroid disorders, anemia, protein deficiency, and low vitamin levels can contribute to hair loss.
  • Lifestyle Factors: Stress, diet, and hair handling practices also play a role.

 When to Seek Medical Advice

 Indicators of Excessive Hair Loss

  • Losing more than 100-150 hairs per day consistently.
  • Noticeable thinning or bald patches.
  • Rapid shedding.

Scales for Measuring Hair Loss

Hair loss is often quantified using standardized scales. These scales help in diagnosing the extent of hair loss, understanding its pattern, and planning treatment strategies. The most commonly used scales are the Norwood-Hamilton Scale for men and the Ludwig Scale for women.

Norwood-Hamilton Scale (For Men)

Purpose: Specifically designed to classify male pattern baldness.


Norwood-Hamilton Scale for Male Pattern Baldness: This illustration shows the seven stages of hair loss according to the Norwood-Hamilton Scale, ranging from no visible hair loss in stage 1 to severe loss in stage 7.


Norwood-Hamilton Scale for Male Pattern Baldness: This illustration shows the seven stages of hair loss according to the Norwood-Hamilton Scale, ranging from no visible hair loss in stage 1 to severe loss in stage 7.

  • Stage 1: Little to no recession of the hairline.
  • Stage 2: Slight recession at the temples.
  • Stage 3: First signs of significant balding; deeper recession at temples.
  • Stage 4: Further frontal hair loss and balding or thinning of the vertex.
  • Stage 5: Hairline recession is severe with a wider vertex area.
  • Stage 6: The bridge of hair that once separated hair loss areas disappears.
  • Stage 7: The most severe stage, only a band of hair going around the sides of the head remains.

– Significance: Helps in determining the progression and pattern of male pattern baldness, aiding in treatment decisions.

 Ludwig Scale (For Women)

– Purpose: Designed to categorize female pattern hair loss.


Figure 12. Ludwig Scale for Female Pattern Hair Loss: This image depicts the three stages of hair loss in the Ludwig Scale, from minimal thinning in stage 1 to extensive balding in the crown area in stage 3.


  • Stage 1: Slight thinning that can be camouflaged with hair styling techniques.
  • Stage 2: Increased thinning and a noticeable decrease in volume.
  • Stage 3: Full balding in the crown region.


This scale is critical in identifying the severity of female pattern baldness, which tends to be more diffuse than in men.

Other Notable Scales

  • Savin Scale: Similar to the Ludwig Scale, but includes nine stages, providing more granularity in assessing the density of hair on the top of the scalp and the frontal area.
  • Baldness Scale by Olsen: Tailored for diffuse thinning seen in female pattern hair loss, focuses more on the thinning aspect rather than the balding pattern.

Utilization in Treatment and Research

These scales are not only used in clinical settings for diagnosis and treatment planning but also in research to evaluate the efficacy of hair loss treatments.

They provide a standardized way to communicate about the severity and pattern of hair loss among medical professionals.

 Significance of These Measurements

  • Consistency in Diagnosis: They offer a consistent and reproducible way to diagnose and categorize hair loss.
  • Treatment Planning: Helps in tailoring treatments according to the severity and pattern of hair loss. For instance, early stages might respond well to medication, while advanced stages might be better suited for surgical options like hair transplants.
  • Progress Tracking: Useful for tracking the progression of hair loss over time and the efficacy of treatment strategies.

Understanding these scales is crucial for both patients and clinicians. It allows for a better grasp of the hair loss situation, facilitating informed decisions about treatment and management.



– American Hair Loss Association

– European Academy of Dermatology and Venereology