The Norwood Scale: Hair Loss Pictures, Stages & More
The Norwood hair scale (also called the Hamilton-Norwood scale) is a seven-stage classification system used to measure and categorize the different stages of male pattern hair loss.
Men affected by hair loss typically don’t lose their hair evenly across their entire scalp. Instead, hair loss caused by male pattern baldness (androgenetic alopecia) follows a specific pattern — yes, that explains the name — that begins in a specific area.
The scale was originally developed by James Hamilton. But it was updated by Dr. O’Tar Norwood, a dermatologist and hair transplant surgeon who revised Hamilton’s classification after he saw different patterns of hair loss in men.
We’ll explain how the Norwood hair scale works and list the seven stages (or Norwood levels) you may go through if you’re losing your hair.
What Are the 7 Stages of Hair Loss?
The Norwood hair scale (sometimes referred to casually as the Norwood chart or the Norwood balding scale) has seven stages that measure the severity, pattern, and progression of hair loss.
Norwood Scale Stage 1
Norwood stage 1 involves no significant hair loss or hairline recession — or just a little bit of hair loss.
Many men have a Norwood 1 pattern before experiencing some level of hair loss as they age. Although uncommon, some men maintain a Norwood type 1 hair pattern for their entire lives.
Norwood Scale Stage 2
A Norwood scale 2 is when you start to notice visible hair loss. At this stage, the early signs of the common M-, V- or U-shaped hairline begin to appear.
Many men notice the first signs of hair loss when their hairline begins to recede around the temples. This might also be called a mature hairline.
Norwood Scale Stage 3
A Norwood 3 hairline is much more visible. During this stage, the hairline recedes more and takes on a clear M or V shape. Some men develop a receding hairline accompanied by small balding areas on the scalp.
Men with hair classified as Norwood 3 have obvious hair loss at the temples and the frontal area of the scalp. Some guys with a Norwood type 3 hairline also experience hair loss at the crown, or vertex. This is referred to as vertex hair loss.
Men with more significant hair loss around the frontal hairline may be classified as having a Norwood type 3A hair loss pattern.
While type 2 areas of hair loss are usually easy to conceal with the right haircut, Norwood type 3 hair loss is much more difficult to hide.
Norwood Scale Stage 4
Norwood 4 hair loss is more severe and obvious. Men with hair loss in this stage have lots of hair loss around the hairline, giving it a noticeable bald appearance.
They also have sparse hair or possibly no hair on the vertex scalp (top of the head).
Many men with stage 4 hair loss have a thick strip of hair separating their hairline from the balding area around the crown.
Norwood Scale Stage 5
As hair loss progresses to Norwood 5, the band of hair separating the hairline and crown becomes smaller and thinner. In this stage, you’ll have significant, obvious hair loss around your hairline and crown.
Some men develop Norwood type 5A hair loss, with more substantial hair loss on the scalp and less of a separating band between the hairline and crown.
For many men affected by balding, this is when the classic horseshoe pattern of hair loss becomes more visible.
Norwood Scale Stage 6
Norwood type 6 hair loss is very severe. By this stage, you’ll have lost almost all hair that previously made up your hairline and vertex scalp.
There may still be a band of hair to separate these areas, but it’ll be sparse and thin.
Though you might still have some hair across your scalp, coverage will be minimal, and your scalp will be clearly visible through your hair in all lighting conditions.
By stage 6 of the Norwood hair scale, the classic horseshoe pattern of hair on the back and sides of the head is easy to see.
Norwood Scale Stage 7
Norwood 7 hair loss is the most severe form of balding. By this advanced stage, almost none of the hair on the scalp will be left, aside from a few stray hairs or small areas with relatively mild hair growth.
At this point, the classic horseshoe pattern of hair around the back and sides of the head will be all that’s left. This hair may be fine and lacking in density.
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Tracking Hair Loss With the Norwood Hair Scale
If you want to be proactive and get ahead of your hair loss (or know when to start treatment), you can use the Norwood hair scale system to track the progression.
Your first move when you start noticing hair loss should be to make an appointment with a certified dermatologist or another healthcare provider who specializes in hair loss.
But, if you’d rather monitor the situation yourself before calling in the heavy artillery, we recommend taking a series of reference photos to use as a visual baseline. Then you can track any changes in your hairline over the next few months or years.
Here’s what to do:
Take one photo of your hairline. Make sure your face and hairline are well-lit, as it can be hard to see your hairline clearly in a poorly lit or underexposed photo. Tilt your head forward slightly so your hairline and the top of your head are both visible.
Next, take a photo of your profile (the side view of your face). Put your smartphone on a shelf and use the self-timer to take a photo of yourself. This will show any change in your hairline around the temples.
Then take a photo of the top of your head. Hold your smartphone above you using a selfie stick and use the front camera. Or ask another person to take your photo. This will show any hair loss on your scalp and crown.
Finally, take a photo of the back of your head. You can do this using a selfie stick or by asking someone else to take your photo. This will provide a clear view of any hair loss at the crown of your scalp.
Every two to three months, take a new set of photos and check for any changes. To make sure you keep regular photos of your hair, set a reminder for every other month using your phone calendar.
You can compare each set of photos to the Norwood hair scale. If your hair advances from one stage to the next, it’s a good signal you’re losing your hair and should think about taking action.
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Understanding How Hair Loss Happens
Before we get into how to treat each type of hair loss on the Norwood hair scale, you should know a bit about the causes of hair loss.
One of the top causes of balding is genetics. (You can learn more about this in our guide to the baldness gene, aka the AR gene.)
Basically, certain people are born with hair follicles that are more sensitive to the hormone dihydrotestosterone (DHT), a naturally occurring male hormone that’s converted from testosterone.
For people with hair follicles sensitive to DHT, even normal amounts of the hormone can cause hair follicles to shrink (a process known as miniaturization). Eventually, they’ll fail to grow, which creates the horseshoe-shaped hair pattern many bald men have.
How Is Hair Loss Treated?
No matter where you are on the Norwood scale, the earlier you take action to treat and prevent hair loss, the more hair you’ll usually be able to keep.
If you notice your hair advancing from one Norwood type to the next — or if you notice a receding hairline or other early signs of balding — take action as soon as possible. If you treat your hair loss while you’re still in Norwood 2 or 3 stages, you might be able to keep most or all of your hair.
As hair loss progresses to the later Norwood stages of baldness, it becomes harder to treat effectively, even with surgical procedures like hair transplantation.
Your best bet is to reach out to a dermatology specialist, trichologist, or another healthcare provider to go over your treatment options.
Hair Loss Medications for Men
At Norwood 3 or 4 stage you should start looking into hair loss treatment options (if you haven’t already). The most common treatments are the medications finasteride and minoxidil, which have been approved by the U.S. Food and Drug Administration (FDA) and can slow down or stop further hair loss.
These medications work in different ways. Finasteride (sold under the brand name Propecia®) blocks testosterone from being converted into DHT and encourages new hair growth.
Also sold as Rogaine®, minoxidil works by moving hair follicles into a state of active growth and stimulating blood flow to the scalp. Essentially, minoxidil keeps the hair growth cycle going by encouraging new hair growth on your head.
Hair Restoration Surgery
At Norwood stage 5 and above, a hair transplant surgery might be a viable option to add some coverage to your scalp and hairline. But remember, you need to have some remaining hair for a transplant to be successful.
You can learn more about it in our guide to hair transplants.
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Final Takeaway on the Norwood Hair Scale
Although it’s imperfect, healthcare professionals and hair transplant surgeons commonly refer to stages of the Norwood scale to diagnose and treat hair loss in men.
Here’s what to keep in mind:
The Norwood hair scale measures male pattern baldness in seven stages to determine the severity and pattern of hair loss.
Norwood stages 1 and 2 signify early signs of hair loss, with either no signs of balding or the beginnings of a receding hairline and noticeable bald spots.
Stages 3 through 5 indicate more significant hair loss and recession of the hairline, while almost all hair is gone in stages 6 and 7.
Early Norwood stages are receptive to treatment from medications like finasteride and minoxidil. Later stages may require hair transplants, though these aren’t always a guaranteed solution.
Healthy hair and regrowth are possible. If you’re curious about effective hair loss treatments, we provide access to finasteride and minoxidil online, with the latter available as a minoxidil foam or a liquid minoxidil solution.
You can also opt for a combination treatment with a topical finasteride & minoxidil spray. Or take them together orally with a compounded minoxidil-finasteride chew.
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment or medication.