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The Norwood Scale: Measuring the Extent of Hair Loss

The Norwood Scale for Male Pattern Hair Loss

The Norwood scale is the standard measure of hair loss progression in men. Androgenetic alopecia (also called male pattern baldness) typically follows a distinct pattern and the Norwood scale captures the various stages of its progression. Level 1 on the Norwood scale describes someone with minimal to no hair loss. At the other end of the scale is Norwood 7, which describes someone who has lost all the hair from the top of their head, leaving just a thin ‘horseshoe’ of hair at the back and sides. Understanding where you are on the Norwood scale is important as it will help determine which hair loss treatments are most suitable.

norwood scale for androgenetic alopecia
The Norwood scale shows the typical progression of androgenetic alopecia.

Norwood 1

Norwood 1

At this stage there are no visible signs of hair loss. The hairline and crown are intact, with no signs of miniaturisation.

If you have a history of androgenetic alopecia in your family, it may be worth keeping an eye out for any signs of recession at the temples or any decreases in hair density. It is far easier to maintain hair than regrow it, so if you do notice any changes, it’s important to act quickly.

Norwood 2

Norwood 2 hair loss

The first sign of hair loss is often a receding hairline at the corners.

It is natural for a man’s hairline to change shape between the ages of 17 and 29. This process is the transition from a juvenile hairline to a mature hairline and is nothing to do with androgenetic alopecia. For some, this transition may be more evident than others.

However, if hairline recession continues (Norwood 2), this may be a sign that you’ll go on to develop further hair loss.

For some, hairline recession affects the central part of the scalp too (Norwood 2V).

When hair loss first becomes evident, this is the best time to act.

Norwood 3

Norwood 3

As hair loss progresses, the hairline continues to recede further back.

For some, hair loss is most evident at the temples, creating a sharp ‘widows peak’ hairline with an ‘island’ of hair in the centre (Norwood 3).

For others, hairline recession is more uniform (Norwood 3A). This may also be the point at hair becomes noticeably thinner at the vertex (crown) area as well.

Norwood 4

Norwood 4

At Norwood 4, hairline recession becomes increasingly severe.

Treatment options at this stage become increasingly limited. It is far more difficult to regrow hair than maintain it. Often, a hair transplant is the only option to regain a full head of hair.

Norwood 5

Norwood 5

By this stage, there is little hair left on the top of the head.

The bald spot at the vertex may meet with the receding hairline at the front (Norwood 5A). Otherwise, there is only a sparse ‘bridge’ of hair separating the two balding areas (Norwood 5 and 5V).

Norwood 6

Norwood 6

At Norwood stage 6, the top of the scalp is now completely bald.

The remaining hair forms a distinctive ‘horse shoe’ at the back and sides of the head.

At this stage, a hair transplant is the only viable option to regain the appearance of a full head of hair. Even the strongest prescription medications – such as dutasteride – are unlikely to make a cosmetically appreciable difference.

Norwood 7

Norwood 7

Norwood 7 is the most extreme form of androgenetic alopecia.

The ‘horse shoe’ area of remaining hair shrinks in area as hair loss progresses from the top of the hair to the sides as well.

Any hair left at Norwood 7 is genetically resistant to further hair loss. This means it can be used as donor hair in hair transplant surgery. However, because hair loss is so advanced at this stage, the number of grafts available will be limited.

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4 thoughts on “The Norwood Scale: Measuring the Extent of Hair Loss

  1. Hi,

    So which treatments are best effective for Norwood 2 phase of hair loss?

  2. Where is the hybdrid scale ? I’m loosing hair on top only…

  3. I have Norwood 5A stage hair loss.
    >how long does procedure take
    >how long is recovery time
    >what are costs approximately
    > how long is procedure effective for
    >how do I set up appointment
    >is there a recovery place to stay
    >what are the most risks

  4. Nerding out:
    There’s something which bugs me a bit about the A pattern scale. The drawer drawn it as if it only has a downsides compared with the “classic” bitemporal recession, especially in grade 2 and 3. I definitely see people with not as pronounced recession on temple corners but which forehead expands from center. Imho Nw3A is “the fivehead”, it’s not receded all the way to the mid line. That’s the classic Nw 3 which center forelock peak is much less receded and sometimes not at all, while the corners are often receded all the way to the mid line, sometimes less sometimes, more rarely, more.
    Nw2 A is indeed one of most subtle and elusive, sometimes it keeps proceding in the A pattern sometimes not.
    But imho you can’t just take off the Nw3 widow’s peak and call it Nw3 A ^_^, that would be Nw4 A or at least one of the phases of this middle of the road pattern.
    Otherwise Jude Law would be Nw3 A except for the mid being a bit more receded.
    Think about Christopher Walken or George Segal, they slowly receded in entire life from just the front, then sort of stabilized and still kept what looks like a high forehead or mature harlines to the end -, at least in the case of George Segal, sadly, and to this day in Walken’s case.
    George Segal young, Nw1
    https://static01.nyt.com/images/2021/03/23/us/23segal-obit/23segal-obit-articleLarge.jpg?quality=75&auto=webp&disable=upscale
    Older
    https://images.mubicdn.net/images/cast_member/22393/cache-2763-1535725531/image-w856.jpg?size=800x
    Very hybrid and particular center thinning, but near no corner recession yet, Nw2 A? If this is not Nw2 A what is it?
    One could have seen this as a literal threat of general thinning than a mature hairline.
    Turned out its not, yet it didn’t exactly stop there.
    Later years
    https://static01.nyt.com/images/2021/03/23/obituaries/23segal-promo/23segal-promo-mobileMasterAt3x-v2.jpg
    some minor corner and further but moderate frontal recession with the former original forelock pretty miniaturized at this point Nw3 or Nw 2.5 A ?
    Last decade as pops in The Goldbergs 78 to 87
    https://filmdaily.co/wp-content/uploads/2021/03/george-lede-1300×866.jpg
    he almost always showed his hairline, we can notice it got higher but it really stabilized in a very credible natural high one, especially given age, but I’d gladly take his at mine! ^_^, only the high resolution shots shows the vestige of what used to be a quite lower hairline, the only sign he used to have more hair.
    I watched the show and of course passingly focused on his hair, he pretty much had a solid crown from the back
    latest with mustache
    https://mr.comingsoon.it/imgdb/SerieTV/news/1/121606_ppl.jpg
    hair pretty much stayed the same with some minor global age related thinning, yet what he lost on front was definitely male pattern.
    Now not sure if this would be too high for Nw3 A and already into 4, but imho the feeling like a naturally high forehead and the corners less recessed than a classic Nw3 would makes this the textbook “pure” Nw3 A pattern.
    But I’d include David Duchovny as well.
    https://images.radio.com/aiu-media/GettyImages859055972-d93576c1-c859-49b3-bb72-1143ab9b8ff1.jpg
    but used to be like this
    https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcRAuLxHzRSl9UpsK1xE1K7mB4T1_kMQ46IHqlkUm4DNBkjHVf74nZ6HLiRDzjEne3VT4GQ&usqp=CAU
    and then like this
    https://64.media.tumblr.com/1a72a75a6f7277cde897392a8b89af30/tumblr_inline_nl2l9nUjdM1ro4yax.gif
    Easily concealed for his return as fox mulder in 2016
    http://vignette2.wikia.nocookie.net/x-files/images/4/4f/Fox_Mulder_2016.jpg/revision/latest?cb=20160122042350

    While I’m one of the bald positive people, though knowing getting bald takes off style option and depending on head shapes the image might change in different ways, not “clothed” and defined/concealed by hair anymore, making me maybe “green” pilled, neither blue or red or worse black pilled, would be awesome if we all got at worst Nw3 classic like Daniel Day Lewis or higher forehead like this guys but solid elsewhere, would look distinguished and “age appropriate” ^_^.

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