Norwood 5 at age 48 means the hair between your frontal recession and crown bald spot has thinned to a narrow band. This is advanced hair loss, but your age is actually an advantage for treatment planning. At 48, your pattern is highly predictable, which allows surgeons and dermatologists to build a strategy with long-term confidence.
What Norwood 5 Looks Like at 48
The frontal and crown areas of hair loss are separated by only a thin, weakening strip of hair. The overall appearance shows extensive thinning across the top of the scalp.
| Feature | Norwood 5 at 48 |
|---|---|
| Frontal hairline | Severely receded |
| Crown | Large bald or very thin area |
| Bridge between zones | Thin, may be transparent |
| Grafts if surgery chosen | 3,000 to 4,500 |
| Donor supply concern | Moderate to high |
Is This Normal at 48?
Norwood 5 at 48 affects roughly 1 in 5 men with hair loss at this age. While most men in their late 40s are at Norwood 3 or 4, reaching Norwood 5 is not rare. It generally indicates that hair loss began earlier (late 20s to early 30s) and has progressed at a moderate-to-fast rate.
By 48, even advanced patterns tend to slow their progression. Moving from Norwood 5 to 6 or 7 over the next decade is possible but typically gradual. This means your current situation is likely to remain relatively stable with treatment.
Treatment Strategy for Norwood 5 at 48
Medication: The Baseline
Medication cannot regrow large bald areas at Norwood 5, but it plays a critical protective role.
Finasteride (1mg daily)
- Halts further loss in 80 to 90% of men
- Prevents thinning of the remaining bridge and donor zone
- Essential for anyone considering transplant surgery
- Side effects in 2 to 4%, reversible
Minoxidil (5% topical, twice daily)
- 40 to 60% regrowth on thinning (not fully bald) areas
- Best applied to the remaining bridge and crown edges
- Complements finasteride
Hair Transplant: Strategic Approach
Norwood 5 at 48 requires thoughtful donor management. Here is the math:
| Resource | Amount |
|---|---|
| Grafts needed | 3,000 to 4,500 |
| Lifetime donor supply | 6,000 to 8,000 |
| Supply used | 40 to 60% |
| Reserve remaining | 2,500 to 5,000 |
With this donor budget, most surgeons recommend one of two approaches:
Approach 1: Single comprehensive session
- 3,000 to 4,500 grafts in one day (FUE)
- Frontal priority with selective crown coverage
- Recovery: 7 to 10 days
- Best for men unlikely to progress much further
Approach 2: Two-session strategy
- Session 1: 2,000 to 2,500 grafts (frontal zone)
- Session 2: 1,500 to 2,000 grafts (crown, 8 to 12 months later)
- Allows assessment of growth before committing remaining grafts
- Better for men with limited donor density
Graft Distribution at Norwood 5
| Zone | Allocation | Why |
|---|---|---|
| Frontal hairline | 30 to 35% | Highest cosmetic impact |
| Mid-scalp | 25 to 30% | Creates appearance of coverage |
| Crown | 20 to 25% | Fills vertex, less visible in daily life |
| Temple points | 10 to 15% | Natural framing |
Cost by Region
| Region | Cost for 3,000 to 4,500 Grafts |
|---|---|
| Turkey | $3,000 to $9,000 |
| USA | $12,000 to $27,000 |
| UK | $9,000 to $22,500 |
| Europe | $7,500 to $20,250 |
Hybrid: Transplant + SMP
The combination of a hair transplant and scalp micropigmentation is highly effective at Norwood 5:
- Transplant handles the frontal zone (real hair, real hairline)
- SMP adds density illusion behind the hairline and across the crown
- Total cost: Transplant + $2,000 to $5,000 for SMP
- Preserves 1,000 to 2,000 donor grafts compared to transplant-only approach
Non-Surgical Path
For men who prefer to avoid surgery:
| Option | Cost | Coverage |
|---|---|---|
| Full SMP | $3,000 to $5,000 | Shaved-look density across entire scalp |
| Hair system | $150 to $400/month | Full, immediate coverage |
| Medication only | $30 to $80/month | Maintenance, minimal regrowth at N5 |
Expected Results Timeline
| Month | Medication Only | Transplant + Medication |
|---|---|---|
| 3 | Slowed loss | Shedding phase, loss stabilized |
| 6 | Stable | 30 to 50% new growth |
| 12 | Maintained | 70 to 85% growth visible |
| 18 | Maintained | Full result, evaluate crown needs |
Next Steps
Norwood 5 at 48 requires a plan that balances restoration goals with donor supply realities. Start medication immediately to protect what you have, then consult a surgeon to map out a graft distribution strategy tailored to your specific anatomy and goals.
Get your free AI Norwood assessment to confirm your stage and evaluate your donor area. Read the complete Norwood scale guide for broader context, or review the hair transplant candidacy guide to assess your surgical options.
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 5 hair loss normal at 48?
Norwood 5 at 48 is in the advanced range but not uncommon. About 20% of men experiencing hair loss by their late 40s reach Norwood 5, where the bridge between the frontal and crown zones has almost disappeared. This stage indicates a moderate-to-fast progression pattern that likely started in the early 30s.
What treatments work best for Norwood 5 at age 48?
A multi-zone hair transplant of 3,000 to 4,500 grafts paired with finasteride is the primary treatment. Medication alone cannot restore coverage at this stage. Adding SMP to transplant results can create fuller-looking coverage while preserving donor grafts. PRP therapy at $500 to $2,000 per session supports thinning zones.
Should I get a hair transplant at age 48 with Norwood 5?
A transplant is viable and can produce significant improvement, but expectations must be calibrated. At 3,000 to 4,500 grafts needed, you will use 40 to 60% of your lifetime donor supply. Surgeons prioritize the frontal zone because it has the highest visual impact. Full density across all zones is unlikely in a single session.