Stages of Hair Loss

Hair loss progresses in recognisable stages, which doctors use to track change and judge treatment.

Pattern hair loss in women (Ludwig scale)

• Stage I: mild thinning of hair at the parting, often noticed only in photos.
• Stage II: clear widening of the parting with more visible scalp.
• Stage III: marked thinning across the top, with a see-through scalp on the crown.

Pattern hair loss in men (Norwood scale)

• Early stages (I to III): the hairline recedes at the temples, giving an M shape.
• Middle stages (IV to V): a bald spot appears at the crown and the hairline recedes further.
• Advanced stages (VI to VII): the bald areas join, leaving a band of hair at the sides and back.

Stages in the hair cycle

Anagen (growth), catagen (short transition) and telogen (rest) are phases of each follicle, not stages of disease. In telogen effluvium, more follicles than usual enter rest at once.

Alopecia areata

It may start with one patch, spread to several, and in a minority extend widely. Many people see regrowth, but relapse is common.

Why staging helps

Treatment works best at early stages, when follicles are only shrinking. Long-standing bald skin with no follicle openings is much less likely to regrow.

Key point

Take a clear photo of the parting every month under the same light. It is the simplest way to see if loss is slowing or progressing.

Before your appointment

Note when shedding began, how much you lose, and any recent illness, fever, surgery, crash diet, new medicine or stress. Bring recent blood reports such as ferritin, thyroid, B12 and vitamin D, a list of the products you use, and monthly photos of your parting. Mention any family history of hair loss or autoimmune disease.