What is your gender?

Male

Female

How old are you?

How many hairs are you losing now?

How do I count the hairs I lose on a daily basis?

You can determine your daily hair loss in three steps:

Each morning, count how many hairs you find on your pillow.
Then comb out your hair over the sink using a comb or a brush. Count the number of hairs in the sink and in the comb/brush.
Repeat this every evening.

The total of these three counts will give you your daily hair loss.

Minimal (0 - 20)

Slightly increased (20 - 40)

Increased (40 - 80)

Many (80 - 120)

Very many (more than 120)

How advanced is your hair loss already?

Stage 1: Full hair with minimal/no recession

Stage 2: Beginning temple recession

Stage 3: Deeper temple recession + early vertex (crown) thinning

Stage 4: Clear baldness developing on crown with temple recession

Stage 5: Larger crown bald area with thinning band between front/back

Stage 1: Full hair with minimal/no recessionStage 6: Temple and crown areas beginning to merge

Stage 7: Final stage - only horseshoe band of hair remains on sides/back 7

Stage I (Mild): Initial, perceptible thinning of the hair along the central part-line on the crown.

Stage II (Moderate): A clearly widening, pronounced separation of the mid-line part and a significant reduction in overall hair density on the top of the head.

Stage III (Severe): Heavy, extensive thinning that creates a sparse or near-bald crown, although the front hairline remains preserved.

Advanced

Do you have dandruff?

Yes

Do you regularly wear tight hairstyles?

These includes:

Braids
Weaves
Extensions
Tight ponytails or buns
Durags or bandanas

Frequently

Rarely

Never

Are you often stressed?

Yes, frequently stressed

Yes, poor or limited sleep

Yes, both stressed and poor sleep

No, neither applies to me

Do you have an increased energy demand?

Yes

Due to competitive sports

Due to fitness training

Due to heavy physical work

Do you have any members in your family already suffer from hair loss?

Yes, on my mother's side

Yes, on my father's side

Yes, on both sides

I'm not sure

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