Norwood 4 at age 38 involves deep recession at both temples and an expanding bald zone on the crown, with a narrowing strip of hair still connecting the two areas. At 38, this pattern has had enough time to define itself clearly, giving you and your surgeon a reliable foundation for treatment planning.
What Norwood 4 Looks Like at 38
By this stage, hair loss has progressed well beyond the temples. The crown bald spot is visible, and the band of hair between the front and back is thinning. At 38, most men at Norwood 4 have been dealing with progressive recession for over a decade.
| Norwood 4 at 38 | Details |
|---|---|
| Temple recession | Severe, 3+ cm from juvenile line |
| Crown | Expanding bald zone |
| Bridge zone | Present but thinning |
| Grafts needed | 2,500 to 3,500 |
| Pattern stability at 38 | Moderate to high |
Treatment Approach
Medication as the Foundation
Regardless of whether you choose surgery, medication protects the hair you still have and slows any further progression.
Finasteride (1mg daily)
- Halts loss in 80 to 90% of men
- Regrowth in about 65%
- At 38, particularly important for maintaining the bridge zone
- Side effects in 2 to 4%, reversible on discontinuation
Minoxidil (5% topical, twice daily)
- 40 to 60% moderate regrowth
- Effective on both temple and crown zones
- Results visible at 4 to 6 months
Hair Transplant Surgery
Norwood 4 at 38 is a well-defined surgical scenario. The graft count is substantial but fits within a single FUE or FUT session.
Procedure Comparison
| Factor | FUE | FUT |
|---|---|---|
| Max grafts per session | 5,000 | 4,000 |
| Recovery time | 7 to 10 days | 10 to 14 days |
| Scar type | Small dot scars | Linear scar (hidden by hair) |
| Graft survival | 90 to 95% | 90 to 95% |
| Donor shaving required | Yes | No |
Cost by Region
| Region | Cost Per Graft | Total (2,500 to 3,500 Grafts) |
|---|---|---|
| Turkey | $1 to $2 | $2,500 to $7,000 |
| USA | $4 to $6 | $10,000 to $21,000 |
| UK | $3 to $5 | $7,500 to $17,500 |
| Europe | $2.50 to $4.50 | $6,250 to $15,750 |
| India | $0.50 to $1.50 | $1,250 to $5,250 |
Zone Prioritization
At Norwood 4, surgeons typically allocate grafts across three zones:
- Frontal hairline (40% of grafts): Creates the biggest visual change and frames the face
- Mid-scalp and bridge (35% of grafts): Connects the hairline to the crown area for a natural gradient
- Crown (25% of grafts): Addresses the vertex bald spot, though this area is less visible in daily interactions
Donor Management at 38
Your donor area at 38 is still in good condition. The 2,500 to 3,500 grafts needed for Norwood 4 represent a moderate draw on your lifetime supply.
| Ethnicity | Avg Donor Density | Lifetime Budget (45%) | After Norwood 4 Surgery |
|---|---|---|---|
| Caucasian | 200 FU/cm2 | ~7,000 grafts | 3,500 to 4,500 remaining |
| Asian | 170 FU/cm2 | ~6,000 grafts | 2,500 to 3,500 remaining |
| African | 150 FU/cm2 | ~5,500 grafts | 2,000 to 3,000 remaining |
These reserves give you a comfortable margin for potential touch-ups in 5 to 15 years if needed.
Why 38 Works Well for Norwood 4
At 38, your hair loss progression has typically decelerated compared to your early 30s. This means:
- The transplant result stays stable longer before any additional loss catches up
- Hairline design can be slightly more aggressive than for a 28-year-old at the same stage
- You have financial stability for the investment
- Your donor area has not yet begun the mild thinning that some men experience in their 50s
Your Action Plan
- Get an AI assessment to map your recession zones precisely
- Start or confirm you are on finasteride and minoxidil
- Gather comparison photos from the past 2 to 3 years to gauge progression rate
- Consult 2 to 3 transplant surgeons for graft estimates and zone planning
- Plan surgery around your schedule (allow 10 to 14 days of reduced visibility)
Read the Norwood scale guide for staging details. Check our transplant candidacy guide for a full readiness evaluation.
Get your free AI hairline assessment to confirm your Norwood stage and see your restoration potential.
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.
FAQ
Is Norwood 4 hair loss normal at 38?
Norwood 4 at 38 falls within the expected range for men with moderate androgenetic alopecia. While not the most common stage at this age, it is far from unusual. It features deep temple recession and an expanding bald area on the crown, with a narrowing bridge of hair between the two. Most men at Norwood 4 by 38 have been losing hair since their late 20s.
What treatments work best for Norwood 4 at age 38?
Hair transplant surgery of 2,500 to 3,500 grafts combined with finasteride 1mg daily provides the best outcome. Finasteride halts further loss in 80 to 90% of men, protecting your native hair and the investment in transplanted grafts. Minoxidil 5% adds additional density. At 38, the combination of surgery plus medication delivers the most complete result for Norwood 4.
Should I get a hair transplant at age 38 with Norwood 4?
Yes, 38 is an excellent age for a Norwood 4 transplant. Your pattern is well-established, your donor area is still dense, and the 2,500 to 3,500 grafts needed fit within a single session. By 38, your rate of progression has typically slowed, meaning the surgical result will stay looking natural for longer. Most surgeons view Norwood 4 at 38 as a straightforward and rewarding case.