What is the Ludwig Scale?

Developed in 1977, the Ludwig Scale is one of two charts used to measure female pattern hair loss (FPH). This system classifies FPH according to its severity, and is good for:

  • Determining the amount of hair that has been lost so far.
  • Estimating how much hair can be lost in the future, if the FPH progresses.
  • Figuring out how to best treat the FPH.

Stages of Severity

According to the Ludwig Scale, there are three stages of FPH:

  • Stage One – a person at this stage of hair loss will experience a gradual thinning of hair on top of the head. Hair loss at this stage may be so mild that it goes unnoticed for some time. Unlike some forms of male pattern hair loss (MPH), the FPH hairline typically does not undergo any major receding. As the hair becomes thinner, the scalp becomes more visible, especially if the person parts their hair down the middle. This stage also includes a picture of a healthy scalp with no hair loss for comparison purposes.
  • Stage Two – a person at this stage is experiencing moderate hair loss. The hairs continue to thin and shed, which causes the hair to have less density and volume in appearance. More and more of the scalp becomes clearly visible, and the hair loss can become noticeable to others. Sometimes a hair transplant is recommended at this stage, but not always.
  • Stage Three – a person at this stage is undoubtedly experiencing a severe amount of hair loss. Hairs typically are no longer found on or around the crown and portions of the midscalp. Hair still may be tall along the sides and the occipital scalp. Miniaturization of the hair follicles has probably occurred by this point.

Is the Ludwig Scale Only for Women?

No, absolutely not. Despite their names, either gender can develop MPH or FPH. While more women develop FPH than males, the Ludwig Scale is developed for both genders. Therefore, if a male were to experience FPH, this chart would equally apply to him as well.

How Common is Stage Three FPH?

Stage three FPH only happens to less than one percent of all women, according to a 2007 study. However, the same study reveals that 12% of all women will experience FPH between the ages of 20-29. Furthermore, over 50% of all women will experience some degree of FPH by the time they reach 80. Overall, while fewer than 45% of women retain a full head of hair throughout their life, most will never reach the third stage of FPH, according to the Ludwig Scale.

The Savin Scale

The Savin Scale is the second most popular chartering system for FPH. The Savin Scale and the Ludwig Scale are extremely similar. The main difference between the two is the final panel of the Savin Scale, which depicts “frontally accentuated” FPH. This is where the hair loss concentrates at the center of the anterior scalp instead of the crown region and temporal vertex regions. Since this is a rarer form of FPH, the Ludwig Scale excludes it.

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