Hair Loss in Men
Male pattern baldness, or androgenetic alopecia, is very common in adult men. It is caused by genetic traits that are passed down through a person’s inherited DNA. The genes can come from either parent. Depending on the age of the patient and the stage of his hair loss, the baldness can typically be classified in one of twelve classes of patterned hair loss described in the Norwood Classification. This system helps determine treatment options and, if the patient is a candidate for a hair transplant, it can aid the physician in designing the hair transplant from an aesthetic perspective.
The diagnosis of male pattern hair loss is initially made by observing the distribution of hair loss and by discussing the patient’s family history of baldness. Close inspection of the balding area with an optical instrument, called a densitometer, enables the physician to note the presence of miniaturized hair in the areas of thinning. Miniaturization — the progressive decrease in hair shaft diameter and length — is a process that is only seen in genetic balding, so the presence of miniaturized hairs indicates a diagnosis of androgenetic alopecia.
Once the diagnosis is made, the discussion about treatment options with the hair restoration physician may begin. In this section, we will focus solely on the causes, classification, and diagnosis of hair loss in men.
Hair Loss in Women
In women, the diagnosis of hair loss is more complex, as the most common presentation of balding, a diffuse pattern, can have a variety of non-androgenetic causes. These may include pregnancy, gynecologic problems, birth control pills, and thyroid disease. Because underlying medical conditions can produce hair loss that closely mimics the diffuse pattern seen in genetic hair loss, a careful diagnostic evaluation by a doctor is particularly important for female patients.
Classification of female genetic baldness is often more simple than in men, since women’s hair loss can be observed in only three patterns or stages. The Ludwig Classification system for hereditary hair loss in women describes diffuse hair loss as Type I (mild), Type II (moderate), or Type III (extensive).
In many cases, the diagnosis of female pattern hair loss is similar to diagnosis in men. The patient will have thinning hair, often on the front and/or top of the scalp, as well as a family history of baldness and miniaturized hairs observed by the physician with a densitometer. However, as mentioned above, hair loss in women can also be caused — or complicated — by underlying conditions, including medical conditions and therapeutic or recreational drug use. Localized hair loss in women, rather than diffuse thinning, can also occur because of medical conditions — as with varieties of scarring alopecia — or due to excessive hair styling — as is the case with traction alopecia. Because of the possibility of non-genetic factors resulting in hair loss, women often undergo additional diagnostic testing in order to confirm the diagnosis.
This section focuses on the causes, classification, and diagnosis of hair loss in women, rather than treatments. However, we recommend that female prospective patients read this information before visiting our office for a consultation.
Hair Loss Facts, Myths & More
Further explore the topic of hair and hair loss in the Hair Loss Facts, Myths & More section. Read about the functions of hair and how it evolved in both animals and humans. The anatomy of hair and hair follicles, and their complex relationship with the skin, is covered in detail. In the page on hair growth you will learn about the three phases of hair growth; the anagen, catagen, and telogen phases. We have all heard the myths about balding, so Dr. Bernstein debunks the ten most frequently spread hair loss myths. Dr. Bernstein also answers several frequently asked questions on hair loss, provides a hair loss glossary, discusses the psychology of balding, shows off the fun side of hair, and more.
Explore the Hair Loss Facts, Myths & More section
The Hair Loss section of this website is devoted to providing details as to the causes, classification, and diagnosis of hair loss in men and women. For information and details on the treatment of hair loss, please view our sections on medical treatment of hair loss and hair transplantation.
Video: When Should I Seek Treatment by a Hair Restoration Physician?
Dr. Bernstein answers a common question on seeking treatment for your hair loss.