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The main stages of alopecia: a classification of the degree of alopecia by Norwood

classification of the degree of alopecia by NorwoodPathological progressive loss of hair is called alopecia.

Alopecia occurs gradually, starting with small areas, gradually spreading throughout the parietal area of the head. If women notice increased loss of hair, even before visible hair loss, most men simply do not pay any attention to this phenomenon until a visible bald spot is formed.

And, after all, the formation of the alopecia are the 4 degree of alopecia.


How is it manifested?

Stages of baldness in men

Hair loss in women

Regressive stage

How is it manifested?

According to the degree of alopecia, 2 large groups can be distinguished: temporary or progressive. Temporary hair loss lasts for several months, it is caused by the influence of negative factors on the body such as stress, hypovitaminosis, the effect of chemicals or radiation.

If the cause is eliminated, the condition of the hair is restored, and their growth resumes.

Progressing alopecia is considered as an independent, most often irreversible disease. It is of a stage character, accompanied by the appearance of patches on the head, devoid of hair, and often leads to complete baldness. There are androgenetic and focal alopecia.

Focal alopecia characterized by the formation on the head of rounded or oval locks with clear boundaries. The disease has mainly an autoimmune nature and is expressed in men and women with the same clinical symptoms.

Androgenetic alopecia is a progressive baldnessAndrogenetic alopecia is a progressive baldness caused by the action of androgen hormones on the hair follicles.

Most often the disease begins in adulthood and is associated with aging of the body.

The process of hair loss occurs gradually, begins with small areas and gradually spreads to other areas of the head.

Alopecia in women and men in androgenetic alopecia manifests itself in different ways.

Men primarily affect the anterior parietal zone along the marginal line of hair growth, in women, baldness begins with a central parting on the crown.

Stages of baldness in men

For the first time the classification of the stages of male pattern baldness was proposed by Hamilton in 1951, it included 5 phases. Later it was processed by Norwood - two more basic stages of alopecia and 6 sub-stages were added.

The stages of baldness in men according by Norwood - Hamilton are characterized as follows:

stages of baldness in men according to Norwood1. I. Alopecia are not observed.

2. II. There is a slight shift of the marginal line back, the frontal depressions become deeper symmetrically, the hair on the central part of the forehead forms a trapezoid.

3. II-A. Shift of the marginal line back together with hairs on the frontal depressions. The front line of hair growth looks almost flat, only slightly protruding forward in the center.

4. III. The boundary line is moved back even further, there is a thinning in the central part, an acute triangle is formed from the "trapezium".

5. III-A. The thinning occurs somewhat more than at stage II-A, the hairs on the frontal depressions and in the center drop out evenly.

6. III-V. Predoenie occurs simultaneously along the anterior edge line, as in stage III, but simultaneously on the upper occipital part a rounded focus of alopecia is formed.

7. IV. The central part thinens, merging with the frontal depressions almost in a flat line, in the upper occipital region forms a rounded bald head.

8. IV-A. The line of hair growth along the front central zone recedes back, farther from the frontal depressions, forming a concave arch.

9. V. The boundary line begins in the center, from the top, outwardly forming a concave arc. The limited center of baldness on the occiput extends to the middle occipital part.

10. V-A. Hairs fall on the entire anterior parietal part, merging with a focus of baldness on the back of the head. But the hair remains in the temporal region.

11. V-V. The hair on the front central frontal part is retained in the form of an acute triangle. The rounded focus of alopecia affects the parietal and upper occipital parts.

12. VI. There are no hair on the parietal, upper occipital and partly in the middle of the occipital region. The hairs in the temporal-lateral part are preserved.

13. VII. Hairs retained in the lower occipital region, and in the lower lateral zone.

Hair loss in men occurs gradually, terminal hard hairs in the foci of alopecia are replaced by thin gun, and then completely disappear.

Alopecia progresses very slowly and lasts for years and decades.

Treatment should be started with a pronounced thinning of the hair.

High pharmacological efficacy in androgenic alopecia in men have drugs for external use with an active ingredient minoxidil (Rogaine 5 or Rogaine 2).

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Minoxidil turns hair follicles into terminal hair follicles and prolongs the active phase of hair growth, preventing them from falling out.

For ingestion appoint finasteride (Propecia), which reduces the concentration of dydrogesterone in the male body, thereby stopping the process of baldness.

With severe alopecia with the appearance of a lesion on the parietal zone of a large area, the only effective treatment is hair transplantation from the lateral and inferior occipital part to the parietal.

We examined all degrees of alopecia in Norwood. In the next paragraph of the article, we will consider the problems of hair relating to the beautiful half of humanity.

Hair loss in women

The stages of hair loss in women were classified by Ludwig in 1977. There are three in total:

1. There is a uniform hair thinning immediately on a large area in the central area of the head.

2. The line of the central parting expands, on the parietal zone the hair becomes thinner. Up to 70% of hair falls in the central zone.

3. A rounded section is formed, completely devoid of hair, in the central parietal zone.

At women with disturbances of endocrine system there is a baldness on man's type. Treatment of alopecia includes the external use of solutions of minoxidil already from the first stage of alopecia, as well as the intake of antiandrogens ("Diane-35", "Cyproterone", "Chloe") inside. In the second and third degree of alopecia, transplantation of active hair follicles is recommended. As a camouflage means used wigs and overhead hairpieces.

Regressive stage

Focal alopecia in patients occurs in 3 stagesFocal alopecia in patients occurs in 3 stages:

1. Progressive or active. Within a few weeks, intense hair loss occurs on the rounded portion of the head until a limited bald spot is formed. The skin in the hearth is edematous, along its edges there are short broken hairs with a thickened tip.

2. Stationary. The skin in the hearth is not changed, the process of hair loss stops.

3. The regressive stage. In alopecia, thin hair can grow along with hard terminal hair.

Treatment of focal alopecia is aimed at enhancing hair growth. Cyclosporine preparations and irritants are used (for inhibition of the autoimmune action of the hair follicles), as well as a solution of minoxidil.

Androgenetic alopecia is most often diagnosed in persons of mature and advanced age. In some cases, baldness in men can begin after the puberty period. Therefore, it is important to diagnose the pathological hair loss in time, especially at a young age, in the early stages for successful treatment.


Let's not forget about the hair, let's take care of them, and at the same time watch our health!
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