World Hair Research

Alopecia can strike anyone for any variety of reasons.  Even newborn babies can be born with this condition.  There are five most common types of hair loss, several other types of alopecia exist, the first five being the most common ones:

• The most common form of baldness is a progressive hair thinning condition, so called Androgenic alopecia or male pattern baldness (MPB).
• Female pattern baldness. The equivalent of MPB, and often is related to Polycystic Ovarian Syndrome (PCOS), malnutrition or wheat/gluten intolerance.
• Alopecia areata, involves the loss of some of the hair from the head, Those with alopecia areata have scattered bald spots all over the head, or one large bald spot confined to one section of the head. It is known as “spot baldness”, it can result in hair loss ranging from just one location (Alopecia areata monolocularis) to every hair on the entire body (Alopecia areata universalis). Alopecia areata, is typically associated with sudden hair loss, sometimes related to trauma, or illness, stress, abusive hair styling such as tight braids and pony tails, wigs, hairpieces or chemicals used on the hair. Alopecia areata is an autoimmune disorder. *4
• Alopecia totalis, involves the loss of all of the head hair, typically be characterized by the complete loss of hair on the head.  The shedding of normal hair will usually occur over a certain amount of time. The sufferers of alopecia totalis will sometime have a small amount of soft Lanugo hair left over after the normal hair has completely fallen out. *7
• Alopecia universalis, which involves the loss of all of the hair from the head and the body, from the top of the head to the legs and feet including eye brows.  Alopecia universalis is the rarest condition of the five most common forms of alopecia. It is thought that alopecial universalis is an autoimmune condition. *5

The following are are thought of as being less common, these can be confused as female/male pattern baldness:

Traction alopecia is most commonly found in people with ponytails or cornrows who pull on their hair with excessive force.

Trichotillomania is the loss of hair caused by compulsive pulling and bending of the hairs. It tends to occur more in children than in adults. In this condition the hairs are not absent from the scalp but are broken. Where they break near the scalp they cause typical, short, “exclamation mark” hairs.

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In women, the hair loss progresses as a diffused thinning of hair all over the top areas and crown of the head (i.e. parietal region). [5] [13] In this case, this hair loss is either referred to as male-pattern baldness, or as female-pattern baldness. [13]

In men, male pattern baldness (MPB) or Androgenic Alopecia (AGA) can be identified and defined visually.

A study published in December, 2004 entitled “Validity of self reported male balding patterns in epidemiological studies” examined and compared the accuracy and reliability of the assessment of balding patterns when conducted by “trained observers” verses assessments of balding patterns conducted by “men” who are experiencing the balding themselves.

In this study, the trained observers and “men” used a classification system known as the “Hamilton-Norwood classification system” (shown below). This study found while it was best to have a trained observer assess the balding pattern, it found that “men’s self evaluation is accurate enough to ensure reliability and validity of results.” In other words, a man should be able to assess his own hair loss pattern using this scale reliably. [*1]

A related article posted today 9/18/2011 Male Pattern Baldness: classification and Incidence – by NORWOOD, O’TAR T. MD features a PDF document with the full text by Dr Norwood himself and his scale.

The Hamilton Norwood Classification Scale was created in 1975 and is shown next.

Figure 1. Hamilton Norwood Classification Scale (OT Norwood, 1975)

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