Female Pattern Baldness

Different criteria must be used to assess the extent of female pattern baldness.

In regard to women and the thinning of hair patterns, there is a distinct relationship between mother, sisters, aunts, and grandmothers. When a history is taken from women who suffer with hair thinning problems, there are generally more than half of the women interviewed who have thinning hair or suffer with baldness, who have female relatives with a similar problem.

Genetic hair loss in women is relatively uncommon and is usually referred to as female pattern baldness or female androgenetic alopecia. In women with this condition, the common pattern will differ to that of men. The pattern of hair loss in men will follow the Norwood classification, the postmenopausal pattern in women is characterized by diffuse thinning starting at just behind the normal hairline and spreading to and beyond the swirl. Unlike men, women with this type of hair loss often have a significant level of miniaturization in the back and side of the scalp. This relates to the decreasing hair shaft thickness in some hair and loss of hairs within the follicular unit.

In some women, the genetic pattern of hair loss is closely related to an increase in male sex hormone - androsterone, testosterone, and DHT. However, in most cases of genetic hair loss, it will occur when the sex hormone levels are normal. Women who develop pattern balding later in life also have a genetic component to their hair loss, however, the relationship is not as strong. The changes which occur at the time of the menopause are an obvious contributing factor.

Due to the fact that genetic hair loss presents itself in a different way in women than it does in men, a different classification system is used. The Ludwig classification, illustrated below, is used by Doctors to describe the thinning that women experience. A Ludwig type 1 is related to the mild widening of the part width. Type 2 will be associated with patients who have increased thinning with moderate widening of the part. Type 3 patients will suffer significant widening of the part width.

A few women will develop pattern balding in a way that is similar to that of men. These patients are therefore better classified using the Norwood classification system and the hair loss will be mainly limited to the front and top of the scalp and won’t affect the back and sides. These patients may well benefit from hair transplant surgery. Approximately 15 per cent of women suffer with this type of pattern balding.