Norwood scale doesn't really apply to diffuse thinners

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This isn't news for many people and I was reading an article awhile back from a transplant site that I showed CCS where they discussed a diffuse thinners hair loss scale, like DA 0, DA, DA2, DA3. The higher, the number the more severe the loss.

I know that I don't fit very well into the Norwood scale as a diffuse thinner with an intact hairline, and I suspect that many other people on here don't either. What do you diffuse guys or others think about this?

http://www.baldingblog.com/2006/05/19/h ... ke-effect/
http://www.newhair.com/resources/mp-1997-evaluation.asp

"Diffuse Patterned Alopecia (DPA) is an androgenetic alopecia characterized by diffuse thinning in the front, top, and vertex of the scalp in conjunction with a stable permanent zone. Diffuse Patterned Alopecia is usually associated with the persistence of the frontal hairline represented by the hairline position of the Norwood Class II or Class III patient. Especially in the earlier stages, the thinning generally extends to the vertex without significant hair loss in the crown. It differs from the regular Norwood classification in that, when the hair loss is first noted, it is already in a stage resembling a thinning Norwood Class VI, rather than having progressed through the Norwood stages III, III Vertex, IV, and V, which are characterized by continued recession at the temples, an expanding vertex/crown, and the presence of a defined bridge separating the anterior and posterior portions of the scalp. In addition, there is an absence of the residual triangular elevation in the parietal region that helps to define the typical Norwood Class VI patient."

What I don't get is the bolded sentence, and maybe some on here can help me with it:


It differs from the regular Norwood classification in that, when the hair loss is first noted, it is already in a stage resembling a thinning Norwood Class VI, rather than having progressed through the Norwood stages III, III Vertex, IV, and V,

Well I noticed my diffuse thinning and I'm definitely nowhere close to a Norwood 6. I have not progressed through stages 3, 4, or 5, yet everyone on here has told me that I am a diffuse thinner.

I know there are other people on here who are in the early stages of diffusing as well and it is noticeable to us, but we haven't gone through norwood 3, 4, or 5.

My situation:

http://img225.imageshack.us/img225/2204 ... 005iw6.jpg

See, intact hairline, but I'm not a Norwood 6 like this article says. It says people will only notice they are a diffuse when they're very late stage.

Another quote from article:

"The earliest stage of loss, in these diffuse alopecias, DA 1 , would be characterized clinically by a "slightly thinning" look in the front, top, and vertex, best visualized under strong lights or when the hair is wet. At other times it might not be noticeable. Almost all patients have subjective complaints of less fullness in the affected areas. Preliminary densitometry studies in the thinning area of these patients have revealed miniaturization to be in the range of 20-50%. DA 2 represents the stage when there is obvious thinning evident under normal lighting, but if the hair is styled properly, the degree of hair loss may be acceptable. Miniaturization for DA 2 is on the order of 50-75%. Patients with DA 3 have significant hair loss in the transplanted area, and the coverage it provides is no longer adequate. The frontal hairline, though still recognizable in it's position as the mature hairline, does not have enough density to frame the face. Miniaturization in DA 3 is usually around 75-95%. The DA 4 patient has lost most of his terminal hair in the balding area (miniaturization > 95%), generally has involvement of the crown, and is similar in appearance to the typical Norwood Class VII."

Maybe us diffusers on here should start referring to ourselves by this possibly more accurate scale.

I guess that would make me a DA2 right? I don't think I'm a DA3 but supposedly a DA2 is equivalent to like a Norwood 3-4 and I am not that far gone yet. My hair is wet in that picture and it is spiked and clumped together.
 

JayBear

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you're right that the norwood scale doesn't seem to apply to us but i imagine any other scale would be dificult to judge without actually counting hairs per square centimeter. things like length and style of hair might make two people with the same level of thinning look completely different. i think my hair has gotten quite thin but because its long and pretty curly its harder to tell when its dry.
 
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yeah i agree with you jaybear. i just hate saying that i'm a nw1.5 when the norwood scale basically goes by hairlines and mine hasnt moved.
 

KR78

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Jayman,

do the big 3 work for diffuse thinners or is there a better treatment.
 
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KR78 said:
Jayman,

do the big 3 work for diffuse thinners or is there a better treatment.

Diffuse alopecia is just another form of genetically inherited male baldness, so the big 3 work for diffusers as well. finasteride may work better for diffuse thinners because while the area of balding is larger, the severity of it in each area is typically not. So you have a better chance at rejuvenating some of those miniaturized hair follicles to a terminal length, in my opinion. nizoral is shampoo so just use that the same way anyone would- leave in for 5 minutes and then rinse. minoxidil is a pain for diffuse thinners because you need to use more to cover all the different balding areas but it may also be more effective for diffuse thinners for the same reason finasteride is.

So, basically, big 3 definitely just as effective for diffusers, and maybe more so, but minoxidil is more of a hassle for us. That's why I'm waiting on it to see what regrowth I get from dutasteride before I decide whether to add minoxidil or not.
 
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