Norwood Scale

Male pattern baldness, or androgenetic alopecia, is the most common form of hair loss in men, affecting millions worldwide. While the severity of hair loss can vary greatly from one individual to another, the Norwood Scale is the most widely used classification system to measure and describe the progression of male pattern baldness. Understanding this scale can help individuals and healthcare professionals track hair loss and choose the right treatment options.

The Norwood Scale is the most commonly used classification system for assessing the progression of male pattern baldness, or androgenetic alopecia. Developed in the 1950s and later refined in the 1970s, the scale provides a visual guide to track the stages of hair loss, from minimal recession to complete baldness. Male pattern baldness affects millions of men worldwide, and the Norwood Scale offers a standardized way for both individuals and healthcare professionals to understand the severity of hair thinning. The scale is particularly helpful in identifying the early signs of hair loss, which can help guide treatment decisions.

The Norwood Scale is divided into seven stages, with each stage representing a different level of hair loss. Stage 1 shows little to no hair thinning, while stage 7 represents the most advanced level, where most of the scalp is bald except for a horseshoe-shaped band of hair around the sides and back. Knowing where someone falls on the Norwood Scale allows for a more tailored approach to treatment, whether that involves medication, hair restoration surgery, or other interventions. It also helps manage expectations by providing a clear visual of how hair loss typically progresses.

Let’s break down each stage of the Norwood Scale to understand the progression of male pattern baldness.

Norwood Stage 1:

No Significant Hair Loss

At stage 1 of the Norwood scale, there is little to no visible hair loss. The hairline is intact, and there are no signs of balding. This stage is generally considered to be a “normal” head of hair with no recession at the temples or thinning.

Norwood Scale 1 Real Pictures And Examples:

The following images are of real life examples of an individaul on the norwood 1 scale of hair loss:

Norwood Stage 2:

Early Recession.

In stage 2 of the Norwood scalle, the hairline begins to recede slightly at the temples, typically forming an M-shape when viewed from the front. The hair loss is still minimal, and most people may not notice the early signs of balding. This stage is often referred to as an “adult” hairline, as many men naturally experience some recession in their hairline during adulthood.

Norwood Scale 2 Real Pictures And Examples:

The following images are of real life examples of an individual on the Norwood 2 scale of hair loss:

Norwood Stage 3:

Moderate Recession.
Norwood Stage 3 is where male pattern baldness becomes more noticeable. The receding hairline at the temples becomes deeper, forming a more pronounced M, U, or V shape. At this stage, the hair loss is more obvious, and some men may begin to experience thinning at the crown. Stage 3 is often a tipping point, where many men start to consider hair loss treatments.

Stage 3 Vertex: In this variation of stage 3, hair loss is most prominent at the crown (or vertex) of the scalp, leading to a noticeable bald spot. The frontal hairline may remain intact, but the crown begins to thin significantly.

Norwood Scale 3 Real Pictures And Examples:

The following images are of real life examples of an individual on the Norwood 3 scale of hair loss:

Norwood Stage 4

Advanced Recession and Thinning
By stage 4, the hairline recession at the temples becomes more severe, and there is noticeable thinning at the crown. At this point, the hair loss in the frontal region and the crown may remain separated by a band of hair, but the balding areas are growing larger and more distinct. Hair loss is becoming more obvious to others, and many men seek out treatments like hair loss medications, mesotherapy or hair transplants.

Norwood Scale 4 Real Pictures And Examples:

The following images are of real life examples of an individual on the Norwood 4 scale of hair loss:

Norwood Stage 5:

Significant Hair Loss
In stage 5, the thin band of hair separating the frontal hairline and the crown begins to narrow, with the balding areas expanding. The hair loss at the temples and the crown becomes more connected, leaving a small, horseshoe-shaped band of hair on the sides and back of the head. This stage marks a more advanced level of baldness, with fewer options for non-invasive treatments to be effective.

Norwood Scale 5 Real Pictures And Examples:

The following images are of real life examples of an individual on the Norwood 5 scale of hair loss:

Norwood Stage 6:

Severe Hair Loss
At stage 6, the hair loss is even more severe, with the band of hair separating the crown and frontal areas of the scalp nearly disappearing. The remaining hair is thin and may not be dense enough to cover the scalp adequately. Hair transplantation is typically the most effective option at this stage for those seeking to restore a fuller appearance.

Norwood Scale 6 Real Pictures And Examples:

The following images are of real life examples of an individual on the Norwood 6 scale of hair loss:

Norwood Stage 7:

Complete Baldness
Stage 7 represents the most advanced stage of male pattern baldness. The top of the scalp is completely bald, with only a thin band of hair remaining on the sides and back of the head in a horseshoe shape. Men at this stage have very limited hair, and the options for treatment are typically surgical, such as advanced hair transplants or hair systems.

Norwood Scale 7 Real Pictures And Examples:

The following images are of real life examples of an individual on the Norwood 7 scale of hair loss:

The Norwood Scale provides a standardized way to measure the severity of male pattern baldness. It is commonly used by healthcare professionals and hair restoration specialists to:

Use The Nordwood Hamilton Scale to Assess hair loss:

The scale helps individuals and doctors objectively track the progression of hair loss over time.

Use The Nordwood Hamilton Scale To Determine Treatment Options:

Different stages of baldness require different treatment approaches. For instance, medications like minoxidil or finasteride may be effective in the earlier stages, while more advanced hair loss might require a hair transplant or other surgical solutions.

Use The Nordwood Hamilton Scale To Set Realistic Expectations:

Understanding where you are on the Norwood Scale can help set realistic expectations for treatment outcomes. Those in the earlier stages may have a better chance of regrowing hair, while those in the later stages may require more invasive procedures for significant improvement.

Author:

Dr. Blake Bloxham, New York Hair Transplant Surgeon