Limited but meaningful hair coverage is achievable at Norwood 7 with the right treatment approach. This is the most advanced stage on the Norwood scale complete guide, characterized by a horseshoe pattern of remaining hair around the sides and back of the head. The entire top of the scalp is bald, and treatment requires either the highest surgical graft count (5,500 to 7,500) or non-surgical alternatives that take a different approach to coverage.
What Norwood 7 Looks Like
Norwood 7 is the final stage of male pattern baldness. Only a narrow band of hair remains, running from ear to ear around the back of the head. The bald area covers the entire frontal zone, midscalp, and crown. The donor band may also show some thinning, which reduces the total number of extractable grafts.
The Core Challenge: Donor Supply Limits
The fundamental constraint at Norwood 7 is that the area requiring coverage is at its maximum while the donor supply is finite. Most men have 6,000 to 8,000 total extractable grafts. Using 5,500 to 7,500 of those consumes nearly all available donor hair. This means every graft must be placed with precision, and the coverage strategy must prioritize visual impact over uniform density.
Surgical Treatment: Hair Transplant
Planning Across Multiple Sessions
Norwood 7 transplant surgery is divided into two or three sessions, each spaced 8 to 12 months apart. A common plan allocates grafts as follows:
Session 1 places 2,000 to 2,500 grafts in the frontal hairline and anterior midscalp. This creates the most visible change because the hairline frames the face. Session 2 adds 2,000 to 2,500 grafts to the posterior midscalp and anterior crown. Session 3, if donor supply allows, uses 1,000 to 2,500 grafts for crown coverage and density refinement.
FUE, FUT, or Both
At Norwood 7, many surgeons recommend combining FUE and FUT to extract the maximum number of grafts over the course of treatment. FUT is performed first to yield a high initial graft count from the donor strip. FUE follows in subsequent sessions to harvest grafts from around the strip scar and other donor areas. This approach stretches the donor supply as far as possible.
Hairline Design at Norwood 7
Hairline placement must be conservative. Placing the hairline too low at Norwood 7 spreads the available grafts too thin, resulting in see-through density that looks worse than a higher, denser hairline. Most surgeons set the hairline at a mature position and focus remaining grafts on creating natural density in the frontal zone.
Realistic Surgical Results
A successful Norwood 7 transplant produces a clearly defined hairline, moderate frontal density, and soft coverage across the midscalp. Full crown coverage at natural density is typically not achievable due to donor constraints. The visual improvement is significant, but patients must understand the difference between "restored" and "full."
Non-Surgical Alternatives
Scalp Micropigmentation (SMP)
SMP is one of the most practical options for Norwood 7. Tiny pigment deposits are placed across the scalp to simulate the appearance of hair follicles at a closely shaved length. The result is a consistent, natural-looking buzz-cut appearance across the entire head.
SMP works as a standalone treatment or as a complement to transplant surgery. When combined with a transplant, SMP fills in the visual gaps between grafts, making the transplanted area appear significantly denser. Three to four SMP sessions are typically needed, with touch-ups every 3 to 5 years.
Hair Systems
Modern hair systems are custom-made to match your hair color, texture, and desired style. They attach using medical adhesive or clips and can be worn continuously for weeks at a time. For Norwood 7, hair systems provide the most complete visual coverage of any option.
The tradeoff is maintenance. Systems need to be cleaned, re-attached, and replaced every 3 to 6 months. Monthly costs typically run $150 to $300 for maintenance appointments and replacement units.
The Role of Medication
Finasteride at Norwood 7
Finasteride halts progression in 80 to 90 percent of men at early stages, but its impact at Norwood 7 is limited to donor preservation. It cannot revive follicles that have been dormant for years across the bald scalp. For transplant patients, it helps maintain donor area density and protect any remaining native hair in the horseshoe band.
Minoxidil at Norwood 7
Minoxidil performs best at Norwood 2 through 4 and has negligible standalone benefit at Norwood 7. The follicles on top of the scalp are too far gone to respond. Some surgeons prescribe it temporarily after transplant surgery to support early graft survival, but it is not a meaningful contributor to the overall result.
Choosing the Right Path
The best Norwood 7 treatment depends on your priorities. If you want actual hair growth, transplant surgery with 5,500 to 7,500 grafts delivers the best physical result. If you prefer a shaved look, SMP provides excellent cosmetic coverage at lower cost. If you want the most complete appearance, a hair system offers full coverage with ongoing maintenance.
Get a precise assessment of your Norwood stage and personalized treatment options at myhairline.ai/analyze.