What´s the Norwood scale and how is it related to baldness?
The Norwood scale (also called the Norwood-Hamilton scale) is a measurement scale used to classify the extent and the stages of male pattern baldness. Is generally accepted by doctors as a standard to describe hair loss and evaluate the severity of baldness in a patient.
It was first introduced by James Hamilton in the 1950s, and later updated by O’Tar Norwood in the 1970s.
The Norwood Hamilton hair loss scale is a very important tool not just to assess the degree of the hair loss, but also to evaluate the possibilities a patient has when considering a hair transplant.
Norwood scale stages
The Norwood scale is divided into 7 stages, from Stage 1 with little or no visible thinning, to Stage 7 with advanced baldness affecting most of the top of the scalp.
Each stage shows a specific pattern of recession at the hairline and crown, making it easier to track how male pattern baldness is progressing over time.
Stage 1
Sometimes referred to as a juvenile hairline, in this stage there is a very minor or no recession at all of the hairline, and therefore no need for treatment. In fact, this is the stage where most boys’ hair will remain until their hairline matures (usually in the late teens and during the early 20s).
Unless you have a family history of baldness you should not worry; however, if there is a family history of male baldness, maybe you want to monitor the situation closely and decide when will be the appropriate time for a treatment.
Stage 2
At this stage triangular and typically symmetrical areas of recession at the front temporal area may be detected, but in general hair loss remains ahead of a line several centimetres in front of the ears. However, initial signs of baldness are becoming evident: hair falls and may become less dense in the central front part of the scalp.
This is a stage of the Norwood balding scale when men begin to feel alarm after noticing a slight recession in their hairline, but actually it doesn’t always means that hair loss is imminent.
Stage 3
The Stage 3 represents the lowest extent of hair loss considered sufficient to be called baldness, according to Norwood. Most scalps at this stage have a deep symmetrical recession showing at the temples that are completely bare or just sparsely covered by hair.
In the Stage 3 vertex, the crown is added and hair loss is primarily located here, with limited recession of the front temporal hairline. This is the point of the Norwood hair loss scale where many men begin to seriously consider a treatment to prevent a further hair loss.
Stage 4
The difference between Stages 3 and 4 can be mild, being the principal that at Stage 4 men will have more recession at the temples, forming a deeper M-shape.
There is also a decisive lack of hair on the crown, with a band of moderately dense hair extending across the top separating the temporal and the crown areas with hair loss.
Stage 5
At this point a small patch of hair may be –or not- still present at the front of the scalp; this is not the case of V a, where the patch is completely gone and the recession of the front line is complete. At this stage the hair loss in 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 also much more narrow and thin. Hair loss on the vertex and front temporal regions is more evident, too. When viewed from above, Stages 5 to 7 show the remaining hair at the sides and back with a horseshoe shape.
Stage 6
Stage 6 is characterized by a deepening of the loss at the hairline and vertex. The bridge of relatively dense hair that once crossed the crown separating the vertex and the temporal region now has been lost with only sparse hair remaining there, so both regions are now joined into one unique area. Also hair loss on both sides of the head extends further.
Stage 7
This is the most severe form of hair loss in the Norwood scale. The only hair that remains at this stage is a strip wrapping from one side to the other on the head in a horseshoe shape. This hair may be less dense than before; however, it can be used as a donor area in case of a hair transplant.
What if my baldness falls within the Norwood scale?
If your hair loss pattern matches one of the Norwood scale stages, it means you can objectively track how far male pattern baldness has progressed and when it is time to start treatment.
Early evaluation helps determine whether medical therapy, PRP, or a hair transplant will give you the best long‑term result.
Using the full 7 stages of the Norwood‑Hamilton scale, a hair restoration specialist can assess the stability of your hair loss, estimate the number of grafts you may need, and design a realistic treatment plan.
This structured approach reduces the risk of over‑ or under‑treating your hair loss and helps set accurate expectations.
If you recognize yourself in any Norwood stage, it is important to consult a hair‑loss professional rather than self‑diagnosing or delaying treatment.
The earlier you start an appropriate therapy, the more native hair can be preserved and the better your final cosmetic outcome will be.
At Clinicana, a leading hair transplant clinic in Turkey based in Istanbul, our medical team uses the Norwood scale during every consultation to diagnose male pattern baldness and plan customized treatments.
You can contact Clinicana for a free, no‑obligation online assessment to find out your Norwood stage and the best solution for your hair loss.
