The Ludwig Pattern of Androgenetic Alopecia Is Due to a Hierarchy of Androgen Sensitivity Within Follicular Units That Leads to Selective Miniaturization and a Reduction in the Number of Terminal Hairs Per Follicular Unit

The Ludwig pattern of androgenetic alopecia is caused by a hierarchy of androgen sensitivity within follicular units, leading to selective miniaturization and a reduction in the number of terminal hairs per follicular unit. Women with androgenetic alopecia have fewer terminal hairs per follicular unit and an increase in the number of vellus hairs, but complete miniaturization of all hairs within the follicular unit is not seen. This supports the hypothesis of a hierarchy of susceptibility within follicular units to androgenetic alopecia. Further investigation is required to ascertain whether secondary and tertiary hair follicles are more susceptible than primary follicles.