As discussed in the section on the causes of hair loss in women, women’s hair loss can be classified into diffuse hair loss, localized hair loss, or patterned hair loss. It can also be divided into scarring and non-scarring types. Since the diffuse, non-scarring female hair loss caused by hereditary is so common, it has its own special classification that is based upon the degree of thinning called the Ludwig classification.

The Ludwig Classification uses three stages to describe female pattern genetic hair loss:

  • Type I (mild)
  • Type II (moderate)
  • Type III (extensive)

In all three Ludwig stages, there is hair loss on the front and top of the scalp with relative preservation of the frontal hairline. The back and sides may or may not be involved. Regardless of the extent of hair loss, only women with stable hair on the back and sides of the scalp are candidates for hair transplant surgery.

Ludwig Hair Loss Classification in Women - Type I - Early Thinning
Type I: Early thinning that can be easily camouflaged with proper grooming. Type I patients have too little hair loss to consider surgical hair restoration.


Ludwig Hair Loss Classification in Women - Type II - Decreasing Volume
Type II: Significant widening of the midline part and noticeably decreased volume. Hair transplantation may be indicated if the donor area in the back and sides of the scalp is stable.


Ludwig Hair Loss Classification in Women - Type III - Thinning
Type III: A thin, see-through look on the top of the scalp. This is often associated with generalized thinning.


It is important for all women experiencing hair loss that an accurate diagnosis is made. This is particularly true when the hair loss is diffuse, as underlying medical conditions may be a contributing factor. Please refer to the diagnosis of hair loss in women page to learn about how the various types of female hair loss are evaluated. Also watch Dr. Bernstein on the Early Show with a female hair loss patient who was treated at Bernstein Medical.

View before and after hair restoration photos organized by the patient’s Ludwig Class

Watch Dr. Bernstein on The Early Show with a female hair loss patient


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