Norwood Scale

Stage 1

Very minor or no recession of the hair line therefore no need for treatment. Unless you have a family history of baldness there is no need to worry. If there is a family history of male baldness (father, brother, uncle, grandfather), you may want to consult a dermatologist to help you monitor the situation closely and decide the appropriate time for treatment.

Treatment: If recommended at this stage there is a good chance you will be able to regain hair that was lost. Recommended treatment is Rogaine at 2 or 5% or Propecia at 1 mg.

Stage 2

Triangular and typically symmetrical areas of recession at the front temporal area. Hair loss remains ahead of a line several centimeters in front of the ears. Hair falls and may become less dense in the central front part of the scalp. Initial signs of baldness are becoming evident.

Treatment: At this stage there is a good chance you will be able to regain hair that was lost. Recommended treatment is Rogaine at 5% or Propecia at 1 mg. A combination of Minoxidil 2% + Retin-A .025% may also be recommended (FDA approval is pending)

Stage 3

This represents the lowest extent of hair loss considered sufficient to be called baldness according to Norwood. Most scalps at this stage have deep symmetrical recession showing at the temples that are bare or only sparsely covered by hair.

With stage 3 vertex, the crown is added since it’s a common occurrence with age. Hair loss is primarily from the vertex with limited recession of the front temporal hairline.

Treatment: At this stage there is a fair chance of regaining lost hair. The recommended treatments are the same as stage 2.

Stage 4

Recession at the front temporal areas is more severe than stage 3. There is a decisive lack of hair on the crown. A band of moderately dense hair extending across the top separates the two areas of hair loss between front temporal and crown. This band bridges between the hair covered areas on the side of the head.

Treatment: With the increased hair loss the amount that may be regained will be reduced. The treatment remains the same as stage 3.

Stage 5

At stage 5 hair loss at the vertex region is still separated from the front temporal region but the division is much less distinct. The band of hair extending across the crown is noticeably narrower and thinner. Hair loss at the vertex and front temporal regions are larger. When viewed from above, stages 5 to 7 show the remaining hair at the sides and back as a distinct horseshoe shape.

Treatment: Extensive hair loss will reduce regrowth capability however treatment that allows you to moving into stage 3 & 4 levels is possible. At this stage hair transplants are another consideration.

Stage 6

The bridge of hair that once crossed the crown is now been lost with only sparse hair remaining. The front temporal and vertex regions are now joined into one area. Hair loss on the sides has extended further.

Treatment: Consider transplants, as other treatments may not respond well to severe hair loss.

Stage 7

This is the most advanced or severe form of hair loss. Only a narrow band of hair in a horseshoe shape survives on the sides and back of the scalp. This hair may be fine and less dense than before. At the nape of the neck the hair is sparse with a semi circle over both ears.

Treatment: Limited options other than transplants.