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Norwood scale
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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 got when thinking about a hair transplant.

Norwood scale stages

The scale comprises 7 stages in total: from the first steps of the hair loss in the stage 1, to the most advanced form of baldness in the stage 7. In the following graphics you can see some Norwood scale examples.

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.

Norwood scale stage 1

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 alarm after noticing a slight recession in their hairline, but actually it doesn’t always means that hair loss is imminent.

Norwood scale stage 2
Norwood scale stage 3

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.

Norwood scale stage 4
Norwood scale stage 5

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.

Norwood scale stage 6

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.

Norwood scale stage 7

 

What if my baldness problem falls within the scale?

In male pattern baldness cases the Norwood scale brings the necessary time to evaluate the process and make a decision. Taking into account all this 7 stages, a hair treatment expert can evaluate the baldness degree, the seriousness of the problem and advise you about the best available options to solve it.

If you believe that you fall on one of the Norwood scale stages, it´s important that you meet a professional in hair loss to receive a proper diagnosis, because the earlier you begin the treatment, the better the results will be. At Clinicana we have the most skilled experts and the best treatments to give you the solution you need for your hair loss problem.