Norwood 5 at age 38 means the frontal and crown bald zones have nearly or fully merged, leaving a horseshoe-shaped band of hair around the sides and back. At 38, this represents a well-defined pattern that gives surgeons a clear picture of what needs to be addressed and how much donor supply is available.
What Norwood 5 Looks Like at 38
The defining feature of Norwood 5 is the near-complete merger of frontal recession and crown baldness. By 38, this pattern has typically been progressing for 15+ years.
| Norwood 5 at 38 | Details |
|---|---|
| Frontal zone | Severely receded, reaching mid-scalp |
| Crown | Large bald area |
| Bridge between zones | Thin or absent |
| Overall pattern | Horseshoe fringe remaining |
| Grafts needed | 3,000 to 4,500 |
| Sessions recommended | 2 |
Treatment Strategy
Medication: Still Essential at This Stage
While medication cannot regrow hair in areas that have been bald for years, it serves two critical functions at Norwood 5: protecting the remaining horseshoe band from thinning, and preserving any miniaturized hair along the edges of the bald zone.
Finasteride (1mg daily)
- Halts further loss in 80 to 90% of men
- Protects remaining native hair around transplanted zones
- Prevents the "shrinking frame" effect where the horseshoe band thins over time
- Side effects in 2 to 4%, reversible on discontinuation
Minoxidil (5% topical, twice daily)
- 40 to 60% moderate regrowth in areas with miniaturized hair
- Useful along the transition zone between bald and preserved areas
- Results at 4 to 6 months
Two-Session Transplant Approach
Spreading the restoration across two sessions protects your donor area and gives each zone time to heal and grow before the second procedure.
Session 1: Frontal Hairline and Mid-Scalp
- 1,800 to 2,500 grafts
- Creates the visible frame of hair that makes the biggest daily difference
- FUE recovery: 7 to 10 days
- Graft survival: 90 to 95%
Session 2: Crown and Density Fill (8 to 12 months later)
- 1,200 to 2,000 grafts
- Addresses the vertex and fills gaps in mid-scalp
- Donor area has fully recovered by this point
Cost Breakdown
| Region | Cost Per Graft | Total (3,000 to 4,500 Grafts) |
|---|---|---|
| Turkey | $1 to $2 | $3,000 to $9,000 |
| USA | $4 to $6 | $12,000 to $27,000 |
| UK | $3 to $5 | $9,000 to $22,500 |
| Europe | $2.50 to $4.50 | $7,500 to $20,250 |
| India | $0.50 to $1.50 | $1,500 to $6,750 |
Donor Budget Planning at 38
At 38, your donor area is in good shape, but Norwood 5 requires careful budgeting for potential future needs.
| Scenario | Grafts Used | Remaining Budget |
|---|---|---|
| Conservative approach (3,000) | 3,000 | 3,000 to 5,000 |
| Full Norwood 5 coverage (4,500) | 4,500 | 1,500 to 3,500 |
| With future Norwood 6 risk | Plan for 1,500 to 2,000 reserve | Adjust session 2 accordingly |
Your surgeon should calculate your exact donor density and lifetime graft budget before committing to a plan. This typically requires a donor area assessment measuring follicular units per cm2.
Complementary Options
Scalp Micropigmentation (SMP)
SMP creates the appearance of density by depositing tiny pigment dots between transplanted hairs. For Norwood 5 at 38, SMP can:
- Fill sparse areas the transplant does not fully cover
- Add the illusion of thickness across the crown
- Work as a standalone option for men who prefer a buzzed look
Low-Level Laser Therapy (LLLT)
FDA-cleared laser caps or combs deliver 650 to 670nm red light to stimulate follicle activity. Results are modest, but LLLT can support overall scalp health as part of a multi-treatment approach.
Realistic Expectations at 38
A Norwood 5 transplant will not recreate the density you had at 20. The goal is a natural-looking hairline, reasonable mid-scalp coverage, and the overall appearance of having hair rather than being bald. When done well, this makes a significant difference in how others perceive your age and how you feel in photographs and social settings.
Your Action Plan
- Get an AI assessment to map your exact recession zones and remaining density
- Start or continue finasteride and minoxidil
- Consult surgeons who specialize in Norwood 5+ restoration
- Request a donor density measurement and lifetime graft budget
- Discuss a staged approach with realistic zone-by-zone goals
Read the complete Norwood scale guide for full staging details. Check our transplant candidacy assessment for readiness evaluation.
Get your free AI hairline assessment to confirm your stage and plan your restoration.
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 5 hair loss normal at 38?
Norwood 5 at 38 represents moderately aggressive hair loss but is not rare. About 15 to 20% of men with pattern baldness reach Norwood 5 by their late 30s. At this stage, the frontal recession and crown bald area have nearly merged, with only a thin or absent bridge of hair between them. The remaining hair forms a horseshoe pattern around the sides and back.
What treatments work best for Norwood 5 at age 38?
A multi-session hair transplant totaling 3,000 to 4,500 grafts is the primary restoration tool, combined with ongoing finasteride 1mg daily. The transplant is typically split across two sessions to protect the donor area. Finasteride halts further loss in 80 to 90% of men, which is critical for maintaining results. SMP can complement surgery for additional density appearance.
Should I get a hair transplant at age 38 with Norwood 5?
Yes, with strategic planning. At 38, your loss pattern is well-established and your donor area is still in good condition. The key is working with a surgeon experienced in advanced cases who can budget your donor grafts for both immediate restoration and any future needs. A two-session approach prioritizing the frontal hairline first delivers the strongest cosmetic outcome.