Male pattern hair loss is nothing new, with more than 50% of all men over the age of 50 expected to experience it in some form or another. It’s not exclusive to men either, as female pattern hair loss affects millions of women all over the world too.

Sticking with the number 50, it was in the early 1950s that the Norwood Scale was created by a Dr James Hamilton, in a bid to help determine the severity of male pattern hair loss that someone may be experiencing. The system was overhauled somewhat in the 1970s (by a Dr O’Tar Norwood) to resemble something we more closely recognise today, and it’s been a helpful tool in the fight against hair loss ever since.

If you’ve been experiencing hair loss and have been looking into what options are available to treat it, then you may have seen the Norwood Scale mentioned once or twice and wondered just what it is. If that sounds about right, then you’ll be glad to know you’ve come to the right place, as we go in depth and break it down and get to the bottom of exactly what’s going on.

So What is the Norwood Scale Exactly?

Sometimes alternatively known as the Hamilton-Norwood Scale, the Norwood Scale is a hair loss ranking system that’s been in place for 70 years now, and has been used by the vast majority of all of the industry’s medical professionals. There are a few other scales that are used too, however the Norwood scale is easily the most popular and the most recognised of the lot.

The Norwood Scale helps surgeons and hair loss professionals to provide patients with a personalised hair loss treatment program, by first establishing an indication of the severity of the patient’s hair loss. There’s usually a fairly specific pattern through which male pattern hair loss does its work, with it usually starting at the temples before working its way back in something of an M shape to the crown. This is the typical shape that male pattern hair loss will take, and the Norwood Scale provides a perfect way in which to measure and assess it.

Different stages of hair loss will ultimately require different levels of treatment, so it’s important to understand these and how they’ll affect your program.

How do the Different Stages Break Down?

The Norwood Scale is comprised of 7 different stages—8 if you include Stage 3 Vertex—and an additional ‘A-Class’ classification for anyone whose hair loss takes on a slightly different shape.

As previously mentioned, the stage at which your hair loss is at will dictate the level of treatment that you’ll receive. The different stages of the Norwood Scale break down as follows:

Stage 1

This is the stage at which most with a healthy and full head of hair will find themselves. There’s no significant hair loss noted at stage 1, and no receding hairline or balding on the crown to speak of.

Stage 2

Those at stage 2 of the Norwood Scale will have experienced a slightly receding hairline, usually just about noticeable around the temples. Again, nothing too notable though.

Stage 3

Stage 3 is where hair loss starts to become a lot more significant. Balding will be noticeable around the temples, and a distinctive M, V or U shape will be starting to set in, whether bald or just super thin.

Stage 3 Vertex

Stage 3 Vertex is where the hair isn’t receding around the temples, but is doing so on the crown (otherwise known as the vertex) of the scalp.

Stage 4

Stage 4 continues with further loss of hair around the temples and the crown, often only separated by a thin, but still noticeable, band of hair on the crown.

Stage 5

With stage 5, this band of hair between the two receding areas is becoming less noticeable. It’s still just about there however, keeping the temples and the crown as two still distinctively balding areas.

Stage 6

When someone makes it to stage 6 of the Norwood Scale, that separating line of hair between the temples and the crown is now completely gone, and the balding parts of the temples are now fully joined as one.

Stage 7

Since this is the 7th and final stage, stage 7 of the Norwood Scale is the most severe level of hair loss, with no hair at all on the top of the head. There’ll still likely be a band of hair around the sides and the back of the head however, as this area isn’t typically affected by the hormone dihydrotestosterone (DHT) that’s responsible for male pattern hair loss.

A-Class

Hair loss typically occurs in separate parts, however with A-Class hair loss, it all happens uniformly, starting at the front of the scalp and slowly but surely making its way backwards.

Is it Possible for Someone to Undergo Hair Transplant Surgery if They’re Toward the Higher End of the Norwood Scale?

Hair transplant surgery is a great way to restore hair to the scalp, providing there’s a healthy donor site available to extract the hairs from. Anyone toward the higher end of the Norwood Scale could likely find themselves without much to work with though, and therefore any results would end up fairly sparse. The further along the Norwood scale anyone is, then the fewer options they’ll have available to them when it comes to treatment.

There are two main techniques when it comes to hair loss surgery: Follicular Unit Transplant (FUT) and Follicular Unit Extraction (FUE). Both are similar for the most part, and both involve taking hairs from a donor site and transplanting them into the balding parts of the scalp. The donor site will need to have a dense enough amount of healthy hair though, which shouldn’t be an issue for anyone finding themselves around stages 1 to 4. Anything beyond stage 4 though and treatment may not be so easy.