Norwood 6 at age 42 means the frontal and vertex bald areas have fully merged into one large zone of loss. Only the horseshoe band of hair around the sides and back remains. This is advanced hair loss, and restoring a natural appearance requires realistic expectations and strategic use of limited donor supply. A hair transplant focused on the frontal zone, combined with supplementary techniques, can produce a meaningful improvement in appearance.
What Norwood 6 Looks Like at 42
At Norwood 6, there is no remaining bridge of hair between the front and crown. The bald area extends from the frontal hairline through the entire top of the scalp to the vertex. The horseshoe band of permanent hair is clearly defined.
Norwood 6 Summary
| Feature | Details |
|---|---|
| Frontal hairline | Absent |
| Vertex | Fully bald |
| Bridge | Fully gone |
| Remaining hair | Horseshoe band |
| Grafts needed | 4,000-6,000 |
| Sessions needed | 2 |
| Full density possible | No, strategic coverage |
The Donor Supply Reality
Before discussing treatment, understanding donor limitations is essential at Norwood 6. This is the defining factor in what can be achieved.
Available Donor Grafts
The safe extraction limit is 45% of donor follicular units:
| Donor Density | Total FU | Safe to Extract (45%) | Enough for Full N6 Coverage? |
|---|---|---|---|
| 150 FU/cm2 | ~6,000 | ~2,700 | No, partial front only |
| 170 FU/cm2 | ~6,800 | ~3,060 | Partial to moderate |
| 200 FU/cm2 | ~8,000 | ~3,600 | Moderate, front focused |
No donor area provides enough grafts for wall-to-wall coverage at Norwood 6. The strategy must be selective. This is not a limitation of the surgeon; it is a biological constraint.
Treatment Options at 42 with Norwood 6
Option 1: Hair Transplant with Strategic Placement
The most common surgical approach at Norwood 6 prioritizes zones based on visual impact.
Phase 1 (Session 1): Frontal hairline and forelock
- 2,000 to 3,000 grafts
- Rebuilds the hairline and frontal frame
- Greatest improvement in appearance from a single session
- FUE recovery: 7 to 10 days
Phase 2 (Session 2, 8-12 months later): Mid-scalp and limited vertex coverage
- 1,500 to 2,500 grafts
- Extends coverage behind the hairline
- Creates a natural density gradient from front to back
Total across both sessions: 4,000 to 6,000 grafts Graft survival: 90 to 95% Full result visible: 12 to 18 months after each session
Cost for Norwood 6 Restoration
| 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 |
Option 2: Transplant Plus Scalp Micropigmentation
SMP is one of the most effective complements to a transplant at Norwood 6. Small tattoo dots between transplanted hairs create the illusion of shaved follicles, making the grafted area appear denser than the graft count alone would suggest.
This combination allows 3,500 to 4,500 grafts to produce a visual result that looks significantly fuller. SMP is particularly effective in the mid-scalp and vertex where graft spacing may be wider.
Option 3: SMP as a Standalone
For men who prefer a closely shaved or buzzed look, SMP alone can create the appearance of a full head of closely cropped hair. It does not produce actual hair growth, but it eliminates the contrast between the bald top and the hair on the sides, creating a cohesive appearance.
Option 4: Hair Systems
Modern hair systems (non-surgical hair replacement) provide immediate full coverage. They attach to the scalp with adhesive or clips and are virtually undetectable when properly fitted. This is an option for men who want full density without surgery or who lack sufficient donor supply for a transplant.
Medication at Norwood 6
Finasteride (1mg daily) still serves a purpose:
- Protects the donor horseshoe from thinning (yes, even the sides can thin in some men)
- Halts loss in 80 to 90% of men
- Supports any transplanted result by preserving surrounding native hair
- Side effects in 2 to 4%, reversible
Minoxidil has minimal impact at Norwood 6 because the affected follicles are largely beyond recovery through topical stimulation alone.
Supplementary Support
- PRP therapy: $500 to $2,000 per session, may support graft survival during the growth phase
- Low-level laser therapy: Limited benefit at this stage, primarily maintenance
- Body hair transplant: Beard and chest hair as supplementary graft sources when scalp donor is exhausted
Setting Expectations
At Norwood 6, the goal is strategic improvement, not full restoration. A well-planned transplant and SMP combination will:
- Restore a natural-looking frontal hairline
- Provide moderate coverage in the front two-thirds of the scalp
- Improve facial framing significantly
- Create a balanced appearance between transplanted and native hair
It will not replicate the density of a full head of hair. Men who understand this going in report higher satisfaction with their results.
Get a Donor Assessment
Your treatment plan at Norwood 6 depends almost entirely on your donor density. This single measurement determines how many grafts are available, how the surgeon distributes them, and whether supplementary techniques are needed.
Get your free AI hair loss assessment at myhairline.ai/analyze to evaluate your stage, map your donor potential, and receive a realistic treatment plan for Norwood 6 at 42.
Review the complete Norwood scale guide for staging information 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.