Know Your Baldness Stage with the Norwood Scale

Hair loss is a common issue among men who are approaching their thirties and forties, some baldness stages occur at an earlier age- for some young people it started at their twenties. Hair loss diagnosis in men is called Androgenetic alopecia or more well-known as male pattern baldness. Frequently, it starts with the receding of the hairline and thinning hair on the crown of the head and it develops in various stages. How its development depends on several factors such as genetics and treatments. 

Before deciding what kind of treatment you need, whether it be medication, food supplement or hair transplant you need to know at which stage you are.

For that reason, we have what is known as the Norwood Scale. It is the standard measure of hair loss progression in men and is the generally accepted standard when describing hair loss. It takes measurements of hair loss in men from stages 2-7.

 Firstly, where does the word Norwood came from? 

Today’s Norwood Scale originated with Dr. James Hamilton in the 1950s who developed the baldness classification system, which was later revised by Dr. O’Tar Norwood in the 1970’s by modifying the stages and adding 3a, 3 vertexes, 4a, and 5a.

The Norwood Scale baldness stages can be explained as follows:

Norwood stage 1

No visible hair loss or minimal hair loss more even there is no receding of the hairline. At this stage no need to worry as the hairline and crown are intact and there are no visible signs of hair loss.

However, if there is a history of androgenetic alopecia in your family, you need to monitor your head and see if you developed any sign of a recession at the hairline or in hair density, at that time you need to look for an appropriate treatment.

Norwood stage 2

Typically symmetrical areas of recession at the hairline. The hair loss initial signs appear in a receding hairline at the corners. The good news at this stage is that it’s very natural for a man between the ages of 17 and 29 to change the hairline shape and it is not androgenetic alopecia.  

Still, if the hairline recession continues and started to affect the central part of the head it might be initial signs of baldness and it is called Norwood 2.

When hair loss is obvious you need to start looking for the appropriate treatment.

Norwood stage 3

In this stage, the same receding pattern as Norwood 2As hair loss progresses. The hairline continues to recede further back into the temporal area creating a look of islands called Norwood 3. For other men the hair recession is uniform and it is called Norwood 3A. Ultimately the hair thinning continues and the crown area may be seen. Definitely, this stage requires treatment.

Norwood stage 4

At this point, hairline recession becomes more severe in the front temporal areas. Additionally, it is the first phase of a bald spot at the back of the head.

For this stage, the treatment options are very limited. Every so often, a hair transplant is the only reliable option to regain hair.

Norwood stage 5

 In Norwood stage 5 the crown area is left with little or even no hair. The hairline and crown areas are separated by few hair usually called ‘bridge’ a thin division line that is still present. The receding hairline might meet the crown area and in this case, it is called Norwood 5A.

Norwood stage 6

At this stage, the bridge is gone leaving the top part of the head completely bald or with only sparse hair remaining.

The remaining hair forms horseshoe shape at the back and sides of the head.

Here, the one and only worthwhile treatment option is hair transplant surgery.

Norwood stage 7

The most severe form of androgenetic alopecia or hair loss is Norwood stage 7.

 The horseshoe shape recedes all the way back to the base of the head and the sides just above the ears. In most cases a little amount of the hair that is left, in other words, it cannot be used as donor hair in hair transplant as the number of grafts available will be limited because of the advanced hair loss. Considering body hair transplant might be a good option at this stage.