the Diagnosis of Progressing Baldness

In order to standardize the diagnoses concerning their patients’ head of hair state, doctors have worked out 2 basic charts with appropriate data (scale). The one chart, called Norwood-Hamilton (Nw.), describes the androgenic progressing baldness of men. The other chart, Ludwig scale, describes the androgenic processing baldness of women. Both charts present thoroughly the process of progressing baldness with the use of large-scale pictures of patients. However, there are cases of excessive casting of hair which cannot be documented according to either the Norwood-Hamilton or Ludwig scale. The large-scale pictures mentioned above describe just the process of androgenic progressing baldness which is proceeding in specific and predictable way, which can be called "a pattern".

It is characteristic for men that their process of androgenic progressing baldness is usually long and in the case of individual patients, it develops in a similar way, as a pattern. The beginning phases of male pattern alopecia are connected with the formation of so-called pilonidal sinuses (Nw. 2-2A) that is loss of hair in the front parts of a head. In time the primary hair line gets thinner and thinner and it moves up (Nw. 2A-3A). In this way the so-called "high-forehead" is formed which is the characteristics of male progressing baldness. If the process of excessive casting of hair cannot be stopped by the proper hair treatment, and a patient’s hair is also sensitive to DHT, then the patient will notice progressive balding in the middle and the top part of his head (Nw. 3V-5).

In more advanced phases of baldness (Nw. 4-5), miniaturization affects hair on all over the head. The last phases (Nw. 5A-7) present the complete baldness. Miniaturization very often does not concern the hair which grows in circumferential parts of a head, i.e. its occipital and temporal parts (Nw.5A, 6, 7), and if it does concern, then to much lesser scale. It has been discovered that there is the genetic dissimilarity between occipital and temporal hair and the hair which usually fall out. It turns out that the hair which usually remains on a head (Nw. 5A, 6, 7) is resilient to DHT which is a kind of active testosterone type responsible for androgenic progressing baldness. This resilience stops hair from falling out as easily as hair in sinuses or in the middle part of a head. This discovery was very important for the development of hair restorative surgery. (The topic of grafts will be described in detail in the new section).