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The
Ludwig female baldness classification system
Female pattern baldness has also been classified although the system
is much simpler than the male classification design. Female pattern
hair loss was arbitarily arranged into three basic types by Dr Ludwig.
The three basic patterns are classed as Ludwig type I, Ludwig type
II, and the most extensive hair loss in women is Ludwig type III.
The classification shows a progressive increase in diffuse hair
loss from the top of the scalp, but the frontotemporal hair line
remains intact.
The Ludwig system takes no account of male baldness patterns developing
in females although this was noted by Ludwig, Hamilton, Dawber and
others. Ludwig suggested that females with male pattern alopecia
should classified according to the Hamilton or Norwood scales.
Minimal diffuse hair loss is the most common form of female alopecia
with up to 80% of affected women presenting with this mild form.
Ludwig pattern III is rare, found in 5% or less of women with androgenetic
alopecia. Based on 468 cases, Ludwig developed the grading system
below.
Type I. Perceptible thinning of the hair on the crown, limited
by a line situated 1-3cm behind the frontal hair line.
Type II. Pronounced rarefaction of the hair on the crown within
the area seen in type I.
Type III. Full baldness (total denudation) within the area seen
in types I and II.
The
Ludwig female baldness classification system references
- Ludwig
E. Classification of the types of androgenetic alopecia (common
baldness) occurring in the female sex. Br J Dermatol. 1977 Sep;97(3):247-54.
- Hamilton
JB. Patterned loss of hair in man: types and incidence. Ana N
Y Acad Dermatol 1951:53;708-28
- Venning
VA, Dawber RP. Patterned androgenic alopecia in women. J Am Acad
Dermatol. 1988 May;18(5 Pt 1):1073-7.
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