Norwood 6 at age 40 means the bridge of hair between the frontal and vertex bald areas has been lost, creating a continuous bald zone across the top of the head. Only the horseshoe band of hair around the sides and back remains. This is advanced hair loss, and while restoration options exist, they require careful planning around donor supply limitations and realistic expectations about coverage.
What Norwood 6 Looks Like at 40
The hallmark of Norwood 6 is the merged bald area. The frontal recession and the vertex thinning are no longer separate zones. Hair remains only in a band extending from above the ears around the back of the head.
Norwood 6 Overview
| Feature | Details |
|---|---|
| Frontal hairline | Absent |
| Vertex | Fully bald |
| Bridge between zones | Gone |
| Remaining hair | Horseshoe band only |
| Grafts needed | 4,000-6,000 |
| Sessions likely | 2 |
| Full density achievable | No, strategic coverage |
The Donor Supply Challenge
The biggest factor at Norwood 6 is donor limitations. You need 4,000 to 6,000 grafts for meaningful coverage, but your donor area has a finite supply.
Donor Math for Norwood 6
The safe extraction limit is 45% of donor follicles. For most men:
| Donor Density | Total Follicular Units | Safe to Extract | Enough for Norwood 6? |
|---|---|---|---|
| 150 FU/cm2 | ~6,000 | ~2,700 | Partial coverage only |
| 170 FU/cm2 | ~6,800 | ~3,060 | Partial to moderate |
| 200 FU/cm2 | ~8,000 | ~3,600 | Moderate coverage |
This means full density restoration across the entire bald area is not possible for most men. The surgical strategy must be selective.
Treatment Strategy for Norwood 6 at 40
Surgical Plan: Strategic Graft Placement
Most hair transplant surgeons at Norwood 6 follow a prioritized approach:
- Frontal hairline and forelock: The highest visual impact zone. A well-designed hairline with 1,500 to 2,000 grafts in the front creates the strongest impression of coverage.
- Mid-scalp zone: Another 1,500 to 2,000 grafts behind the hairline to build depth.
- Vertex: Given remaining donor supply, vertex coverage may be light or deferred to a later session.
Procedure details:
- FUE: 7 to 10 days recovery, small dot scars, up to 5,000 grafts per session
- FUT: 10 to 14 days recovery, linear scar, up to 4,000 grafts per session
- Graft survival: 90 to 95% for both techniques
- Two sessions spaced 8 to 12 months apart is standard for Norwood 6
Cost Expectations
| Location | Cost per Graft | Total for 4,000-6,000 Grafts |
|---|---|---|
| Turkey | $1-2 | $4,000-$12,000 |
| USA | $4-6 | $16,000-$36,000 |
| UK | $3-5 | $12,000-$30,000 |
Medication: Protecting What Remains
Finasteride (1mg daily) is still important at Norwood 6. It:
- Halts further loss in 80 to 90% of men
- Protects the horseshoe donor area from thinning
- Stabilizes any remaining wispy hairs in the transplant zone
- Side effects in 2 to 4% (sexual, reversible)
Minoxidil has limited impact at Norwood 6 because most affected follicles are beyond the miniaturization phase. However, applying it to areas with residual thin hairs (particularly if the vertex still has some coverage) may provide marginal benefit.
Scalp Micropigmentation: The Density Multiplier
SMP is one of the most effective complements to a hair transplant at Norwood 6. Small tattoo dots between transplanted hairs create the illusion of greater density. This combination allows a transplant of 3,500 to 4,000 grafts to look like significantly more coverage than the graft count alone would produce.
SMP can also be used as a standalone treatment for men who prefer a shaved or buzzed look. It creates the appearance of a full, closely cropped head of hair.
Other Options
- PRP therapy: $500 to $2,000 per session, primarily for supporting transplanted grafts during the growth phase
- Hair systems: High-quality non-surgical hair replacements that clip or bond to existing hair, providing immediate full coverage
- Body hair transplant: Chest or beard hair as supplementary donor grafts when scalp supply is exhausted
Setting Realistic Expectations
At Norwood 6, the goal shifts from full restoration to strategic improvement. A well-executed transplant will:
- Recreate a natural-looking frontal hairline
- Provide moderate density in the front two-thirds of the scalp
- Improve the overall framing of your face
- Require ongoing finasteride to maintain native hair support
It will not produce the same density as someone with a full head of hair. Men who understand this distinction are consistently more satisfied with their results.
Assess Your Donor Potential
Donor density is the single most important variable at Norwood 6. An accurate measurement determines what coverage is achievable and how many sessions you will need.
Get your free AI hair loss assessment at myhairline.ai/analyze to map your Norwood stage, evaluate donor capacity, and build a realistic restoration plan for Norwood 6 at 40.
Review the complete Norwood scale guide for stage details or check your hair transplant candidacy assessment.
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.