Norwood 4 at age 60 represents moderate to advanced hair loss with both temple recession and vertex thinning. This is a common stage for men in their 60s, and the good news is that your options remain strong, particularly because your pattern has almost certainly stabilized by now.
What Norwood 4 Looks Like at 60
Norwood 4 is defined by significant frontal recession combined with an enlarged thinning zone at the crown (vertex). A bridge of hair still connects the front and crown areas, but it is noticeably thinner than at earlier stages. The overall pattern creates a visible horseshoe shape beginning to form.
At 60, this stage typically represents the endpoint of your hair loss journey rather than a midpoint. Most men who reach Norwood 4 by their 40s or 50s stay at this level for the remainder of their lives.
Treatment Strategy for Norwood 4 at 60
| Approach | What It Addresses | Expected Outcome |
|---|---|---|
| Finasteride + Minoxidil | Maintenance and regrowth | Halt loss (80 to 90%), regrowth (40 to 65%) |
| FUE transplant | Hairline and vertex restoration | 90 to 95% graft survival, natural density |
| PRP therapy | Overall density improvement | 30 to 40% density increase |
| Combination (meds + transplant) | Full restoration | Best long-term results |
Medical Treatment
Even at 60, medication plays an important supporting role.
Finasteride (1mg daily) halts further loss in 80 to 90% of men and produces regrowth in about 65%. At 60, prostate health is a consideration. If you already take finasteride at 5mg for BPH, discuss the hair loss benefits with your urologist, as the BPH dose provides hair loss protection as well.
Minoxidil (5% topical, twice daily) works through a different mechanism by increasing blood flow to follicles. It produces moderate regrowth in 40 to 60% of users and is especially useful for vertex thinning. Side effects are limited to scalp irritation in most cases.
Surgical Options
A hair transplant at Norwood 4 requires 2,500 to 3,500 grafts. This graft count addresses both the receded hairline and the thinning vertex area. FUE is the most popular technique, offering:
- Recovery in 7 to 10 days
- Graft survival of 90 to 95%
- Small dot scars (0.7 to 1.0mm) that are virtually invisible
- Up to 5,000 grafts per session if needed
At 60, you have the advantage of complete pattern stability. A surgeon can allocate grafts precisely without needing to reserve a large buffer for future recession.
Transplant Costs for 2,500 to 3,500 Grafts
| Location | Cost per Graft | Total Estimate |
|---|---|---|
| USA | $4 to $6 | $10,000 to $21,000 |
| UK | $3 to $5 | $7,500 to $17,500 |
| Turkey | $1 to $2 | $2,500 to $7,000 |
| Europe | $2.50 to $4.50 | $6,250 to $15,750 |
| India | $0.50 to $1.50 | $1,250 to $5,250 |
| Thailand | $1.50 to $3 | $3,750 to $10,500 |
Donor Area Considerations at 60
Your donor area (the horseshoe-shaped band of permanent hair) may have thinned slightly with age. A qualified surgeon will assess your donor density, measured in follicular units per square centimeter. Healthy donor density is 170 to 230 FU/cm2 for Caucasian men, 120 to 180 for African hair types, and 140 to 200 for Asian hair types.
The safe extraction limit is approximately 45% of donor follicles. Going beyond this can create visible thinning in the donor zone, which would be counterproductive.
Non-Surgical Alternatives
If surgery is not appealing, consider these options:
- PRP therapy: $500 to $2,000 per session, 30 to 40% density improvement over 3 to 4 sessions
- Scalp Micropigmentation (SMP): Creates the appearance of density through tattooed follicle dots
- Hair fibers and concealers: Immediate visual improvement with no medical intervention
Get Your Personalized Assessment
Upload a photo at myhairline.ai/analyze to get a free AI assessment of your exact Norwood stage, donor area health, and personalized treatment recommendations based on your age and pattern.
Medical disclaimer: 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.