Though both men and women suffer from hair loss, unlike male pattern baldness, we don’t know what necessarily causes female-pattern baldness. As far as the time at which women may lose hair, the range in age is similar to men. It can occur as early as after puberty, or begin much later in life when they enter menopause. In postmenopausal women, hair may begin to minitiaturize over the entire head, thereby losing its original volume and becoming difficult to style. Aside from AGA, genetics can be the causative factor, health issues such as iron deficiency or hormonal imbalance that arise from pregnancy, menopause, withdrawal of oral contraceptives, or hysterectomy can also spur hair loss in women. Due to its wide variety of causes, hair loss in a woman should never be assumed to be AGA. Examination and diagnosis by a physician, endocrinologist, dermatologist, and a hair restoration specialist are essential before any hair transplant is undertaken.
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Hair Loss Causes In Women
The Ludwig Hair Scale
The most commonly used classification for female-pattern hair loss is the Ludwig classification (Type 1 to 3). Alternatively, for women who suffer from male-pattern baldness, the Norwood-Hamilton classification can be used. The Ludwig classification emphasizes the diffuse nature of much female-pattern hair loss with a frequently preserved hairline and thinning affecting the central top portion of the scalp, while the Norwood-Hamilton classification describes patterns of loss that are similar to mae hair-loss patterns with affected hairline and/or thinning in the vertex area.
LUDWIG SCALE OF FEMALE HAIR LOSS
Hair loss in women differs from hair loss in men due to the nature of how the hair changes. For women, the affected areas can thin significantly but rarely become totally bare of hair. The following are the most common types of hair loss patterns for women:
- A “Christmas tree” pattern of diffuse hair loss, with the “base” of the “tree” at the hairline and the “tip” of the “tree” at the center of the scalp. Difficulty parting their hair may be experienced here and may result in a type of comb-over to hide the area that is thinning. This type of pattern is the most common type of female hair loss pattern and is easy to fix with hair transplantation because their donor area is usually unaffected.
- A “diffuse” pattern of hair loss that spreads throughout the top scalp. There is a visible pattern of thinning that affects the top scalp and often the temporal areas as well making these women less favorable candidates for a hair transplant.
- A type of “Male-pattern baldness” with preserved central (mid-frontal forelock) density. The regular female-shaped hairline is impacted by a loss of hair in both corners.
- A hair loss found in women (and rarely in men) called diffuse unpatterned alopecia exhibits hair thinning throughout the entire scalp, usually combined with global miniaturization. Due to this, these individuals are not applicable candidates for a hair transplant.
- Traction alopecia is a hair loss caused by repeated pulling out of the hair from a specific area of the scalp. This can occur in African-American women who wear their hair braided. The result can be hair loss in the hairline and/or in the front and above their ears. A hair transplant is still possible in this case as long as there is a good amount of donor density.
- Being born with a high hairline. Classified more as an aesthetic condition rather than medical, it is still seen in female hair transplantation.
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