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The Norwood Scale: What Are the 7 Stages of Male Pattern Baldness?

  • 18th July 2023
  • 11 min read
Arran
Written by Arran Isherwood
Nikos Zakynthinakis
Medically reviewed by Dr. N Zakynthinakis - GMC No. 7011402 on 25th July 2023
Next review due on 25th July 2024

Whether you've been aware of your hair loss for a while or have recently started noticing a receding hairline, understanding the Norwood Scale can give you a clearer picture of the extent of your hair loss and what treatment options may be available to you. 

We'll walk you through everything from the different stages of the Norwood Scale with helpful visuals to what stage of hair loss you can get a hair transplant.

 

What is the Norwood Scale?

The Norwood Scale is a classification system used to measure male pattern baldness — also known as androgenetic alopecia — which affects 6.5 million men in the UK, according to the NHS

The scale acts as a guide with easy-to-reference images, showing you through the different stages of receding hairlines and baldness. In other words, it helps determine the extent of hair loss and provides a reference when discussing treatment options with a professional. 

 

What does hair loss look like for each stage of the Norwood Scale?

 

 7 stages of the Norwood Scale

Source: Wikimedia

 

What are the 7 stages of the Norwood Scale?

The Norwood Scale consists of seven stages, which represent the different patterns and severity of male pattern baldness. 

Stage 1 

This stage indicates a normal hairline with no significant hair loss or recession. 

Stage 2

During stage two, the hairline starts to recede slightly, usually around the temples, creating an “M” shape. The receding hairline may become more evident over time, and there might be a noticeable thinning of hair in the frontal area.

Stage 3

Hair loss becomes more noticeable as the temples recede further, forming a deeper "M" shape. There may also be thinning at the crown (top) of the head.

Stage 4

The recession at the temples continues to progress, and the thinning at the crown becomes more prominent. The hairline may appear more distinct with a larger "M" shape.

Stage 5

The receding hairline and thinning at the crown become more pronounced, with a larger bald area at the top of the head. There is a thin band of hair remaining which separates the frontal and crown bald areas.

Stage 6

The bald areas on the crown and frontal regions begin to merge, leaving a strip of hair connecting them very thin, or it may even have completely fallen out. 

Stage 7

This stage represents the most advanced form of male pattern baldness. Only a narrow horseshoe-shaped band of hair remains on the sides and back of the head, while the top and front areas are extensively bald.

 

How long does it take to progress through the Norwood Scale?

The time it takes to progress through the Norwood Scale can vary significantly among individuals, depending on various factors like genetics, hormones, age, and overall health. Some people may experience a slow and gradual progression over many years, while others may experience more rapid hair loss over a few months.

It's also important to note that the Norwood Scale is not a linear progression, and not everyone goes through all the stages. Some may remain in the early stages of hair loss throughout their life, while others may experience the more advanced stages. 

 

What causes male pattern baldness?

The main culprit behind male pattern baldness is dihydrotestosterone (DHT), a hormone derived from testosterone. And some people have hair follicles that are more sensitive to DHT, which can shrink them and make the hair they produce thinner and shorter. Eventually, these follicles can stop producing new hair altogether, leading to baldness in certain areas, typically at the hairline and on the top of the head. 

This type of hair loss commonly runs in families, so if your dad or grandad had thinning hair, you might be more prone to it too. But remember: everyone's experience is unique, and it's always a good idea to chat with a healthcare professional for a more detailed understanding of your specific situation.

 

Can male pattern baldness be prevented?

Male pattern baldness cannot be completely prevented. It's primarily influenced by genetics and hormones, so if you're genetically predisposed to it, it's likely to happen at some point. However, there are certain measures you can take, like living a healthy lifestyle and using topical treatments, to slow down your progression through the Norwood Scale. 

 

Everyday tips for healthy hair 

While it may not prevent or reverse male pattern baldness, living a healthy lifestyle can certainly promote growth and even help slow the progression of balding. Here are some simple, everyday things you can do: 

Eat a balanced diet

A well-rounded diet, with a focus on diverse food groups, not only benefits your overall health but also contributes to the vitality of your hair. It ensures your hair receives the essential vitamins, minerals, and proteins required for optimal growth and strength. 

Since hair is made up of protein, it's important to include protein-rich foods in your diet. Lean meats, poultry, fish, eggs, legumes, and dairy products are excellent sources that can provide the building blocks necessary for a healthy head of hair. 

And focusing on foods which contain vitamins like iron — which carry oxygen to the hair follicles, encouraging them to grow and repair — is crucial. Think leafy greens, red meats, and lentils. 

Manage stress

While stress itself does not directly cause male pattern baldness, it can potentially worsen it. When you experience stress, the body releases stress hormones like cortisol, which can affect the production and activity of DHT — a hormone associated with male pattern baldness — disrupting the normal hair growth cycle

Incorporating stress-management techniques into your routine, like exercise, meditation, and deep breathing, can help reduce stress levels and promote a better environment for your hair to thrive. 

Avoid tight hairstyles 

Tight hairstyles like ponytails, which pull on the hair strands, can cause hair loss over time. This condition is known as traction alopecia, and it occurs when the hair strands are constantly pulled, causing damage to the follicles. And for people who are already predisposed to male pattern baldness, this added strain could increase the thinning or receding of hair in affected areas. 

Try to be gentle with your hair and opt for looser hairstyles that don't tug on your roots!

Stop smoking 

Not only is smoking associated with conditions like cancer and lung disease, but it can also contribute to hair loss. Smoking reduces blood circulation around the body, including to the hair follicles, potentially disrupting the normal hair growth cycle.

So it's not surprising that quitting smoking can help slow the progression of male pattern baldness.

To learn more about slowing and preventing hair loss, read our tips for healthy hair.

 

How can hair loss be treated?

While lifestyle changes can support overall hair health and potentially slow down the progression of hair loss in the early stages, they may not directly address underlying causes like hormonal imbalances or genetics. Specific treatments or surgery may be needed to manage them or restore lost or thinning hair.

Common treatments include: 

Minoxidil 

Minoxidil  — also known as Regaine — is a widely used treatment for male pattern baldness, as well as other forms of hair loss. It's available as a topical solution or foam and is applied directly to the scalp, where it can prolong the growth phase of hair follicles. 

Whether you are in the early stages of hair loss (such as Norwood Scale 1 or 2) or have progressed to more advanced stages (such as Norwood Scale 3 or beyond), minoxidil can be used to promote hair growth. 

Finasteride 

Another popular treatment option for male pattern baldness is Finasteride. It comes in pill form and works by blocking the enzyme responsible for converting testosterone into dihydrotestosterone (DHT), which is a hormone linked to hair loss. By reducing DHT levels in the scalp, finasteride can help slow hair thinning and even promote some hair regrowth.

It's usually taken once a day, and you may start noticing the effects after a few months of consistent use. 

As with any medication, it's a good idea to have a chat with a healthcare professional before starting finasteride to discuss if it's suitable for you and to learn about any potential side effects.

Hair transplant

Hair transplant surgery is a more permanent solution to hair loss, providing results that should last you a lifetime when you choose a reputable clinic like FUE Clinics. The transplanted hairs seamlessly blend with your existing hair, resulting in a natural look that can significantly boost your confidence and self-esteem.

There are two methods of hair transplantation, but both ultimately achieve the same results. At FUE Clinics, we offer both, including: 

  • Follicular Unit Extraction (FUE) — This involves individually extracting healthy hair follicles from the donor area, typically the back or sides of the head, using a specialised punch tool. These follicles are then transplanted into the areas of thinning or baldness, creating a natural-looking hairline and density. FUE is a more popular procedure due to being less invasive and leaving fewer scars compared to FUT. 
  • Follicular Unit Transfer (FUT) — This is the process of removing a strip of scalp from the donor area before dissecting it into individual follicular units for transplantation. Then, the folliculars are transplanted into the problem areas in the same way as the FUE method.

Check out our guide to learn more about what to expect from your hair transplant.

 

At what stage of the Norwood Scale can you get a hair transplant?

Although hair restoration can yield excellent results, it's not for everyone. If your hair loss is significant, it may be impossible to achieve a full head of natural-looking hair with a transplant. This is why the consultation phase is so crucial to explore the available options and understand what can be achieved.

Surgeons can use the Norwood Scale to measure the extent of your hair loss. The ideal time to get a transplant is when you're past stage three of the Norwood Scale. At this point, balding usually stabilises, so your surgeon will be able to see the pattern of your hair loss, minimising the risk of needing additional procedures in the future. 

Advanced stages of hair loss may require more extensive procedures and careful evaluation of the available donor hair. But here's the good news: thanks to advancements in hair transplantation techniques, successful outcomes can still be achieved, even if you're in a later stage of hair loss.

Read our guide to find out if you're the right candidate for a hair transplant, or book a free hair transplant consultation with one of our experts. 

 

Choose FUE Clinics for your hair transplant

No matter what stage of the Norwood Scale you think you’re at, our expert surgeons at FUE Clinics are here to help you understand if you’re a candidate for a hair transplant. 

Book a free, no-obligation consultation to learn more about the process and how we can help you achieve your desired hair restoration goals. Or, check out our  FAQ section to discover more about our clinic and the procedures we offer.

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