Norwood 4 at age 48 means you have deep frontal recession combined with thinning or baldness at the crown. A band of hair still connects the two areas, but overall coverage has decreased noticeably. At 48, your hair loss pattern is well-defined, making this a practical stage for effective treatment planning.
What Norwood 4 Looks Like at 48
Norwood 4 presents as advanced frontal recession paired with an expanding bald spot on the crown. The mid-scalp bridge is intact but may be thinning.
| Feature | Norwood 4 at 48 |
|---|---|
| Frontal recession | Severe, deep M-shape |
| Crown thinning | Moderate to significant |
| Mid-scalp bridge | Present but narrowing |
| Grafts if surgery chosen | 2,500 to 3,500 |
| Progression risk | Low to moderate |
Is This Normal at 48?
Norwood 4 at 48 is very common. Among men with visible hair loss in their late 40s, Norwood 4 is one of the most frequently observed stages. It typically develops between ages 38 and 52, so being at this stage at 48 places you squarely in the middle of the expected range.
At 48, the speed of progression tends to be slow. The jump from Norwood 4 to 5 often takes many years in men who have already reached their late 40s. This gives you time to plan without urgency.
Treatment Strategy for Norwood 4 at 48
Medication: Protect and Maintain
Medication forms the foundation of any treatment plan at Norwood 4.
Finasteride (1mg daily)
- Halts further loss in 80 to 90% of men at any age
- Produces regrowth in 65% of users, strongest on the crown
- Side effects in 2 to 4%, reversible
- Essential before and after surgery
Minoxidil (5% topical, twice daily)
- 40 to 60% moderate regrowth
- Best results on crown and mid-scalp thinning
- Complements finasteride for stronger effect
Hair Transplant: Strong Candidate
At 48 with Norwood 4, you have several factors working in your favor:
| Factor | Assessment |
|---|---|
| Pattern predictability | High (stable at 48) |
| Graft requirement | 2,500 to 3,500 (single session) |
| Lifetime donor supply | 6,000 to 8,000 grafts |
| Donor usage | 30 to 45% |
| Remaining reserves | Ample for future touch-ups |
| Healing at 48 | Comparable to younger patients |
Procedure Comparison
| Detail | FUE | FUT |
|---|---|---|
| Max grafts per session | 5,000 | 4,000 |
| Recovery | 7 to 10 days | 10 to 14 days |
| Graft survival | 90 to 95% | 90 to 95% |
| Scarring | Small dot scars | Linear scar |
| Donor preservation | Moderate | Better (leaves more for future) |
For Norwood 4 at 2,500 to 3,500 grafts, FUE is the most common choice. If you are concerned about needing additional grafts later, FUT preserves slightly more donor capacity.
Graft Allocation Strategy
| Zone | Graft Percentage | Priority |
|---|---|---|
| Frontal hairline | 35 to 45% | Highest, frames the face |
| Mid-scalp | 25 to 30% | Connects hairline to crown |
| Crown | 25 to 30% | Fills vertex area |
| Temple points | 5 to 10% | Defines natural frame |
Cost by Region
| Region | Cost for 2,500 to 3,500 Grafts |
|---|---|
| Turkey | $2,500 to $7,000 |
| USA | $10,000 to $21,000 |
| UK | $7,500 to $17,500 |
| Europe | $6,250 to $15,750 |
Non-Surgical Supplements
| Treatment | Cost | Benefit |
|---|---|---|
| PRP therapy | $500 to $2,000/session | 30 to 40% density increase in thinning zones |
| LLLT (laser cap) | $200 to $1,500 device | Modest maintenance support |
| SMP | $2,000 to $5,000 | Fills in sparse areas between grafts |
What Results to Expect
| Timeline | What Happens |
|---|---|
| Day 1 to 10 | Recovery, avoid strenuous activity |
| Month 1 to 3 | Transplanted hair sheds (normal), medication working |
| Month 4 to 6 | New growth begins appearing |
| Month 8 to 12 | 60 to 80% of final result visible |
| Month 12 to 18 | Full density achieved |
At Norwood 4, a successful transplant combined with medication produces a result that looks natural and youthful without appearing overdone. The age-appropriate hairline designed for a 48-year-old will continue to look right at 55, 60, and beyond.
Next Steps
Norwood 4 at 48 is a well-understood, highly treatable stage. Start medication to protect your existing hair, then consult a surgeon for a transplant plan that accounts for your donor supply and long-term goals.
Get your free AI Norwood assessment to confirm your stage and receive personalized graft calculations. Read the complete Norwood scale guide for full context, or review the hair transplant candidacy guide to prepare for your surgical consultation.
Medical disclaimer: This article is for informational purposes only and does not replace professional medical advice. Consult a board-certified dermatologist or hair restoration surgeon before starting any treatment.
FAQ
Is Norwood 4 hair loss normal at 48?
Yes. Norwood 4 at 48 is a common presentation for men with male pattern baldness. By the late 40s, more than half of men show visible hair loss, and Norwood 4 with its combined frontal recession and crown thinning is a frequent stage. Progression from Norwood 4 typically slows at this age.
What treatments work best for Norwood 4 at age 48?
A hair transplant of 2,500 to 3,500 grafts combined with finasteride (1mg daily) delivers the best results. Finasteride halts further loss in 80 to 90% of men and protects native hair surrounding transplanted grafts. Minoxidil adds crown regrowth of 40 to 60%. Surgery and medication together produce outcomes neither achieves alone.
Should I get a hair transplant at age 48 with Norwood 4?
Yes. Age 48 with Norwood 4 is a well-suited profile for hair transplant surgery. Your pattern is mature and predictable, the graft requirement (2,500 to 3,500) fits comfortably in one session, and your donor area has had decades to demonstrate its stability. Surgeons can confidently design a result that ages naturally.