Female pattern baldness stages

Female Pattern Baldness Stages | Complete Guide

Female pattern baldness stages will help make hair loss a history

Hair loss in females is associated with female pattern baldness that affects millions of women around the world.

But stages of balding is aiming to help you navigate through the sea of misinformation to find the facts and get you on the road to an effective best hair loss treatment plan.

What is female pattern baldness stages?

Utilizing the Ludwig Scale, we highlight the various stages of hair loss due to female pattern baldness and what treatment approach best addresses your individual needs.

This means unlike male or female pattern baldness in the Hamilton-Norwood Scale, which is used to assess male pattern baldness stages, female pattern baldness is classified using Ludwig Scale into three stages (sometimes known as grades): mild, moderate, and severe.

Women’s Hair Loss Stages

Utilizing the Ludwig Scale, we help you identify exactly what type of female pattern baldness you are experiencing and your level of possible progression.

No signs of Hair Loss

Female Pattern Baldness Stages

The hair looks healthy, thick, and you can’t see any scalp through the hair.

∙ Stage 1 (Grade 1 of female pattern baldness)

Female Pattern Baldness Stages 1

This is the first early sign of female pattern baldness, which has some mild, where hair thinning is noticeable evenly distributed on the scalp. At this thinning stage hair loss is undetectable, and even little hair loss techniques hairstyles can hide it. 

∙ Stage 2 (Phase 2 of female pattern baldness)

Female Pattern Baldness Stages 2

Hair loss in the moderate stage, but it is becoming more visible to the naked eye, with a widening of the midline part and a decrease in hair volume. Hair is thinner in 50 percent to 70 percent on top, and baldness is noticeable.

∙ Stage 3 (Grade 3 of female pattern baldness)

Female Pattern Baldness Stages 3

This is where extensive hair loss is the most severe stage of hair loss, with more scalp showing than hair, necessitating female pattern hair loss reversible treatment is required. 

Male or female pattern baldness treatments right approach

  1. Early treatment. 
  2.  The sooner you act, the more likely you are to retain, maintain and regain.
  3. Be consistent. 
  4.  Once you start a treatment regimen you must follow through with it for at least 6 months…..real results take time.
  5. Stay POSITIVE. 
  6.  Millions (maybe Billions) of women like you are also fighting the good fight so stay POSITIVE, you are not alone. Together we will one day transcend hair loss.

Hair transplant treatment options…..

With constant updates and advancements in the field of hair transplantation, this option is well worth a second look.

Topicals and non-surgical options…..

If the cost of hair transplants are out of your reach, then there are a host of non-surgical options to choose from.

Female pattern baldness stages treatment options

Oral medications

Oral minoxidil (brand name Loniten) is a medication for female pattern hair loss (FPHL). It is approved by the U.S. Food and Drug Administration for prescription by a physician.


There is still no complete “cure” for baldness. But topical hair loss treatments such as special shampoos and various scalp treatments can complement proven treatments such as Finasteride, Minoxidil or surgical hair restoration.


One of the most common factors that make hair loss or thinning hair obviously is that, normally, hair color is darker than the scalp. Hair loss concealers discreetly hide see-through spots. Thinning hair on light skin and dark hair are most obvious. Hair loss concealers such as concealing sprays, concealing fibers, and concealing powders minimize the contrast between scalp and hair color.

Hair transplants

Hair transplantation is a surgical technique that involves moving individual hair follicles from one part of the body (the donor site) to bald or balding parts (the recipient site). It is primarily used to treat male pattern baldness. In this case, grafts containing hair follicles that are genetically resistant to balding are transplanted to the bald scalp.

DHT inhibitors

DHT Blockers work by inhibiting the 5-alpha-reductase enzyme. Basically, a DHT blocker and 5-alpha-reductase enzyme fit together like a puzzle. When that happens, the enzyme can’t join with testosterone to make DHT. Thus, DHT levels go down, and our hair loss stops. In many cases, hair will also grow back.

Growth stimulants

Products that many believe will stimulate existing hair growth. Some products work by enhancing cells and vascular proliferation, while others may prolong the anagen phase of the hair cycle.

Androgen hormones in female androgenetic alopecia

The accepted view of the relation between androgens and androgenetic alopecia is that hyperandrogenism is more commonly associated with a male pattern of balding, i.e. frontal recession and vertex balding. Many hyperandrogenic women, on the other hand, have a female pattern of hair loss, whereas those who have a male pattern do not always have androgen excess. 

The exact roles of androgen over-production, activity, and androgen receptors in androgenetic alopecia in women are still unclear. Although it is rather evident that testosterone is necessary for the development of male balding, there are no systematic studies to support the same in women. However, clinical experience suggests that balding is common in women with hyperandrogenism, especially when it is accompanied by other signs of androgen excess such as irregular menstruation, infertility, hirsutism (increased secondary sexual and facial hair), acne, and oily skin.

Female Pattern Baldness Pictures

The type and proportion of the various androgens produced, both centrally and peripherally are different in men and women. Approximately 30 percent of a woman’s testosterone is produced in the ovaries; the other 70 percent is derived from the transformation of adrenal androgen precursors such as dehydro epiandrosterone (DHEA) and androstenedione, both of which decline with age.

The overall production of testosterone by the ovaries is far less than that of the testes, resulting naturally in a much lower plasma level of testosterone in women than in men. However, the more abundant weak androgens serve as a source of precursors for potent androgens, which provide the physiologic or pathophysiologic androgen activity. Only a small fraction of androgens exists as free steroids in the circulation, with equilibrium between free hormones and protein-bound androgens.

Therefore, in some women, there may be hyper secretion of androgens like androstenediol or testosterone, or DHEA or androstenedione by the adrenal gland or ovary. The skin is capable of synthesizing active androgens from the systemic precursor DHEA sulfate. Interconversion of these hormones at the level of the hair follicle leads to increased tissue levels of the active hair follicle androgen, dihydrotestosterone (DHT). DHT is a potent stimulator of hair loss in the scalp.

The most critical protein for androgen binding is sex-hormone binding globulin (SHBG). Sex hormone-binding globulin is a glycoprotein synthesized by the liver. Many studies show that SHBG levels co-relate inversely with the severity of the alopecia. The more potent androgens and estradiol are bound in the plasma to SHBG, although the binding affinities differ. In DHT, the affinity is three times that of testosterone and nine times that of estradiol. Elevated testosterone causes SHBG synthesis to decrease, in addition to increased activity of 5 -Reductase, the enzyme responsible for the metabolism of testosterone to DHT.

Research outcomes

Several researchers have examined circulating androgen levels in women with scalp hair loss, and there is little doubt of the androgen-dependent nature of pattern hair loss seen in some women with marked androgen excess, either exogenous or endogenous. Experimental studies show that women often precipitously lose hair in a typical Hamilton-IV pattern with a deep bi-temporal recession, and their hair loss may improve when the precipitating cause is removed.

The hair loss in women with hirsutism, acne, and female pattern hair may respond to antiandrogen therapy, substantiating the theory of androgen dependence in some women with female pattern hair loss.
On the other hand, some observations have further questioned the role of androgens in female pattern hair loss. Norwood described families where female pattern hair loss appeared to be inherited independently of male balding, and in a single case report female pattern hair loss occurred in a young woman who lacked circulating androgens or other signs of postpubertal androgenization.

The 5 -Reductase inhibitor, Finasteride, is effective in the treatment of male balding but, in a randomized controlled trial, failed to prevent the progression of hair loss in postmenopausal women with female pattern hair loss and normal androgen levels.


Most women with female pattern hair loss, however, do not have any signs or symptoms of hyperandrogenemia, and serum testosterone levels in such women are typically normal. Definitely, there are reports of varying percentages of women with female pattern hair loss who have elevated androgens, but this does not clearly mean that female pattern hair loss is androgen dependant. Observations made by researchers collectively suggest that androgens play a role in female pattern hair loss, but that an androgen-independent mechanism could also be involved in some women. Therefore, the relationship between systemically elevated androgen levels and alopecia in women is difficult to determine, leaving the condition to be called idiopathic in most women, as suggested by some authors.

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