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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.
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