Androgenetic alopecia follows a predictable pattern of progression that the Norwood scale classifies into seven stages. Each stage corresponds to specific graft requirements, treatment options, and cost ranges. Knowing your current stage and likely progression is the foundation of any effective hair loss treatment plan.
This guide maps each Norwood stage to the clinical reality of androgenetic alopecia, including exactly what to expect and what your options are.
The Norwood Scale and Androgenetic Alopecia
The Norwood-Hamilton scale was developed in the 1950s and refined in the 1970s. It remains the standard classification system for male pattern baldness. The scale describes how DHT-driven miniaturization progresses across the scalp in a predictable sequence, starting at the temples and crown, then expanding until only a horseshoe-shaped band of hair remains.
Understanding the causes of androgenetic alopecia helps explain why this pattern is so consistent: follicles on the top and front of the scalp carry androgen receptors that respond to DHT, while follicles on the sides and back do not.
Stage-by-Stage Mapping
Norwood 1: No Significant Hair Loss
No visible recession or thinning. This is the baseline for comparison. No treatment is needed, though men with strong family history of hair loss may consider early preventive treatment with finasteride.
Norwood 2: Slight Temple Recession
| Detail | Value |
|---|---|
| Pattern | Slight recession at the temporal areas |
| Grafts needed | 800-1,500 |
| Cost range (USA, $4-$6/graft) | $3,200-$9,000 |
| Cost range (Turkey, $1-$2/graft) | $800-$3,000 |
| Recommended approach | Medication first; transplant if recession is cosmetically bothersome |
Norwood 2 represents the earliest visible stage of androgenetic alopecia. Many men at this stage respond well to finasteride alone (80-90% halt further loss, 65% experience regrowth). A transplant is optional but can restore a more youthful hairline.
Norwood 3: Deep Temple Recession
| Detail | Value |
|---|---|
| Pattern | Deep M-shaped recession at temples |
| Grafts needed | 1,500-2,200 |
| Cost range (USA) | $6,000-$13,200 |
| Cost range (Turkey) | $1,500-$4,400 |
| Recommended approach | Medication + transplant for hairline restoration |
This is the most common stage at which men first seek transplant consultation. The M-shape is clearly visible and difficult to conceal with styling alone.
Norwood 3 Vertex: Temple Recession Plus Crown Thinning
| Detail | Value |
|---|---|
| Pattern | Temple recession with thinning at the vertex (crown) |
| Grafts needed | 2,000-2,800 |
| Cost range (USA) | $8,000-$16,800 |
| Cost range (Turkey) | $2,000-$5,600 |
| Recommended approach | Medication + transplant to both hairline and crown |
The vertex variant adds crown thinning to the temple recession. This stage requires more grafts because two separate areas need coverage.
Norwood 4: Frontal and Vertex Expansion
| Detail | Value |
|---|---|
| Pattern | Further recession with enlarged vertex area, thin band separating zones |
| Grafts needed | 2,500-3,500 |
| Cost range (USA) | $10,000-$21,000 |
| Cost range (Turkey) | $2,500-$7,000 |
| Recommended approach | Transplant (FUE up to 5,000 max or FUT up to 4,000 max) + medication |
Norwood 4 is manageable in a single FUE session for most patients. Medication is essential to protect the thin bridge of hair between the frontal and vertex zones.
Norwood 5: Narrowing Bridge
| Detail | Value |
|---|---|
| Pattern | Separation between front and vertex narrowing significantly |
| Grafts needed | 3,000-4,500 |
| Cost range (USA) | $12,000-$27,000 |
| Cost range (Turkey) | $3,000-$9,000 |
| Recommended approach | Large single session or staged procedures + ongoing medication |
Norwood 5 pushes the upper limits of a single FUE session. Some surgeons recommend splitting the procedure into two sessions for optimal density.
Norwood 6: Horseshoe Pattern Forming
| Detail | Value |
|---|---|
| Pattern | Bridge between areas lost, horseshoe pattern visible |
| Grafts needed | 4,000-6,000 |
| Cost range (USA) | $16,000-$36,000 |
| Cost range (Turkey) | $4,000-$12,000 |
| Recommended approach | Multiple sessions likely needed; FUT may maximize graft yield |
At Norwood 6, donor supply becomes a limiting factor. The safe extraction limit of 45% of the donor area must be respected. FUT (strip method) can sometimes yield more grafts than FUE at this stage.
Norwood 7: Most Extensive Hair Loss
| Detail | Value |
|---|---|
| Pattern | Only a narrow horseshoe band remains |
| Grafts needed | 5,500-7,500 |
| Cost range (USA) | $22,000-$45,000 |
| Cost range (Turkey) | $5,500-$15,000 |
| Recommended approach | Multiple sessions, realistic expectations, consider hair system for full density |
Norwood 7 requires the most grafts and may exceed what the donor area can safely provide. Combining a transplant for the hairline with a hair system for the crown is a practical strategy at this stage.
How Fast Does Androgenetic Alopecia Progress?
Progression speed varies widely between individuals. Some men reach Norwood 3 by age 25 and stabilize there. Others progress from Norwood 2 to Norwood 5 over a decade. Factors that influence speed include your specific genetic variants, DHT levels, whether you are on medication, and overall health.
Starting finasteride early can slow or halt progression entirely in the majority of users, preserving more options for the future.
Determining Your Current Stage
Accurately identifying your Norwood stage is the most important step before choosing any treatment. Overestimating your stage can lead to unnecessary procedures. Underestimating it can mean inadequate treatment planning.
Get your Norwood stage identified for free. Use the AI-powered hair analysis tool at myhairline.ai/analyze to see your current stage, estimated graft needs, and personalized treatment recommendations. Check your hair transplant candidacy in minutes.
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult a board-certified dermatologist or hair restoration specialist before starting any treatment.