March 20, 2020

Norwood Scale for hair loss – Knowing where you stand

The Norwood scale for hair loss (also known as Hamilton-Norwood scale) is the most common method of measuring the progression of male pattern baldness in men. Although it was invented in the 1950s, and later improved in the 1970s, it is still widely used today.

This method uses 7 different stages to classify the stages of male pattern baldness, with each stage associated to a common hair loss shape pattern. Let’s have a look at the 7 different stages of male pattern baldness.

The 7 stages of male pattern baldness

Stage 1:

The first stage of the Norwood scale is the stage we all strive to be in. It is the perfect stage where hair loss doesn’t exist at all, the hair is full, and there are no signs of baldness. Unfortunately, we hair loss sufferers slowly move from this stage to the next advanced stages.

Stage 2:

In this stage, hair loss only begins as there is a slight hair recession around the temples. It might not even be noticeable if the hair is long. Most of the hair still looks full at this stage.

Stage 3:

This is where things start to get interesting. Hair loss becomes noticeable as the hair line significantly recedes backwards forming an M or V shape. Hair loss is most apparent on the front and temples.

Stage 3 vertex:

During this stage men will experience significant hair loss on the crown (the vertex). The receding hair line will be less visible than in stage 3 though.

Stage 4:

The hairline recedes even further, and there is very little hair or none on the temples. There is a bald spot on the crown as well. The crown and the receding hairline are connected by a strip of hair which also connects to the hair on the sides.

Stage 5:

This stage is a progression of the previous stage 4. The shape of the hair is the same, but in this stage the strip of hair between the receding hair and the balding crown is even smaller.

Stage 6:

The front and top of the head are mostly bald in this stage. The strip of hair that used to connect the two areas is now gone, and these areas are now joined together. There is little hair left on the sides of the scalp.

Stage 7:

The last stage. The hair on the sides of the head is almost gone too. What remains is the part of the hair that is not DHT sensitive, which is on the lower back side of the head and on the sides just around the ears.

At which stage should you start treating hair loss?

The sooner you start treatment, the better. Ideally it would be best to start treatment during stage 2, or in the early stages of stage 3. During these stages it becomes critical to stop hair loss, as most hair follicles are still producing hair and hair growth is still significant.

It is still possible to regrow some hair at stage 4, but it becomes much harder since many hair follicles have already stopped producing hair. At stage 5 and above it is probably pointless to start medical or topical treatments, but it could be a good idea to consider a hair transplant.

Currently available male pattern baldness treatments

If you decide to treat your baldness, fortunately there are some great treatments available. The two most common and FDA approved treatments are Finasteride (sold under the brand name Propecia) and Minoxidil.

But there are other treatments you can try, like Topical Finasteride which has far less side effects than propecia.

A Derma Roller is another good option, especially when used with Minoxidil. It is a hand held device with a cylinder roller that is covered with small needles, and is used to stimulate the production of a protein that leads to hair growth, and inhibit a protein that causes hair loss.

Other options include PRP treatments, natural DHT blockers, and Ketoconazole (Nizoral) shampoo.

Conclusion

The Norwood scale is a great tool to measure your current male pattern baldness stage, and predict its progression. It is used extensively by doctors and patients, and also by researchers when conducting a hair loss study.

Knowing at which norwood stage a person is can help determine the best course of treatment.

I hope you enjoyed this post, and if you have any questions or comments please add them below.

6 thoughts on “Norwood Scale for hair loss – Knowing where you stand

  1. Hi this was a very informative post. I often wondered why some people lose hair and others do not. I am a woman but when my thyroid condition was untreated I was losing so much hair, thankfully that almost stopped. There are also regrowth products for women. Would they work the same as the mens formula? Thanks for the article I know your website will help many people!!

    1. H! indeed there are some regrowth products that can be used by both men and women. These include Minoxidil, a derma roller device, natural DHT blockers like saw palmetto, and perhaps a PRP treatment as well.
      Michael.

  2. Well done on creating a very informative post, because a lot of men experiencing hair loss has no idea in what category they fall, but it does become important when discussing possible treatment options. This article is therefore a good point of reference.

  3. Hi! Interesting post. Didn’t know there are so many stages of male pattern baldness. After reading your post, get to learn at which stage still got chance to search for treatment. I can actually share this info to my colleague who actually has hair loss problem. Thank you!

  4. Good informative post on the stages of hair loss and when to start treating it.

    What do you recommend if the hair doesn’t grow back? Is there a solution for this.

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