The Norwood Scale classifies male pattern baldness into 7 distinct stages. Developed by Dr. O'Tar Norwood in 1975 as a refinement of Hamilton's earlier work, it remains the standard reference used by hair transplant surgeons worldwide. Understanding your Norwood stage is the first step toward choosing the right treatment.
What Is the Norwood Scale?
The Norwood Scale (formally the Hamilton-Norwood Scale) measures the progression of androgenetic alopecia in men. Each stage describes a specific pattern of hair loss, from minimal recession to extensive baldness. Roughly 80% of men will experience some degree of pattern hair loss by age 80, according to data from the International Society of Hair Restoration Surgery (ISHRS).
The scale includes 7 primary stages plus a "Class A" variant where hair loss progresses front-to-back rather than following the typical vertex-first pattern.
Stage 1: No Significant Hair Loss
Norwood 1 represents a full head of hair with no visible recession. The hairline sits at or near its juvenile position. No treatment is required at this stage, though men with a family history of baldness may consider preventive measures.
Graft requirements: 0 grafts needed.
Stage 2: Slight Temple Recession
The hairline begins to recede slightly at the temples, creating a subtle M-shape. This is often called a "mature hairline" and affects most men by their late 20s. Many dermatologists consider Norwood 2 a normal adult hairline rather than true hair loss.
Graft requirements: 800 to 1,500 grafts if treatment is desired.
Stage 3: Deep Temple Recession
Temple recession deepens significantly, forming a clear M-shape or U-shape. This is typically the earliest stage where hair loss becomes cosmetically noticeable and is the minimum stage where most surgeons will consider a transplant.
Graft requirements: 1,500 to 2,200 grafts.
Stage 3 Vertex (3V)
A subtype where thinning also appears at the crown (vertex) while temples are receding. This pattern requires treatment planning for both zones.
Graft requirements: 2,000 to 2,800 grafts.
Stage 4: Further Recession with Crown Thinning
The frontal recession extends further back, and the vertex bald spot becomes larger. A bridge of hair may still connect the front and crown areas, but it is noticeably thinner.
Graft requirements: 2,500 to 3,500 grafts. FUE with Sapphire blades is commonly recommended at this stage.
Stage 5: Bridge Narrowing
The bridge of hair between the front and crown narrows significantly. The two areas of loss are close to merging. Coverage becomes challenging with a single session.
Graft requirements: 3,000 to 4,500 grafts. Combined FUE and DHI techniques may be recommended.
Stage 6: Bridge Lost
The bridge between the frontal and vertex regions is gone. A horseshoe-shaped band of hair remains on the sides and back. This stage typically requires multiple sessions.
Graft requirements: 4,000 to 6,000 grafts across 2 sessions.
Stage 7: Most Extensive Loss
Only a narrow band of hair remains along the sides and back of the head. The remaining donor area is limited, and body hair transplant (BHT) may supplement scalp donor grafts.
Graft requirements: 5,500 to 7,500 grafts across 2-3 sessions.
Treatment Options by Stage
| Stage | Primary Treatment | Surgical Option | Estimated Cost (Turkey) |
|---|---|---|---|
| 1 | Monitoring only | Not recommended | N/A |
| 2 | Finasteride + Minoxidil | Optional FUE | $1,600-$3,000 |
| 3 | Medication + PRP | FUE recommended | $3,000-$4,400 |
| 4 | Medication + FUE | Sapphire FUE | $5,000-$7,000 |
| 5 | FUE + DHI combo | Multi-technique | $6,000-$9,000 |
| 6 | Multi-session FUE | 2 sessions needed | $8,000-$12,000 |
| 7 | Multi-session + BHT | 2-3 sessions | $11,000-$15,000 |
How to Determine Your Norwood Stage
The most accurate way to determine your Norwood stage is through a consultation with a board-certified hair transplant surgeon. However, AI-powered tools can provide a reliable initial assessment. Start a free AI analysis to get your Norwood classification in 30 seconds.
Key factors your surgeon will evaluate include hairline position relative to the glabella (the area between your eyebrows), temple recession depth, vertex thinning extent, and donor area density.
FAQ
What is the Norwood Scale?
The Norwood Scale (Hamilton-Norwood Scale) is the standard classification system for male pattern baldness. It categorizes hair loss into 7 stages, from Stage 1 (no significant hair loss) to Stage 7 (most extensive pattern).
What Norwood stage requires a hair transplant?
Hair transplants are typically considered starting at Norwood 3. Stages 2-3 may benefit from medication alone, while Stages 4-7 usually require surgical intervention for meaningful restoration.
How many grafts do I need for my Norwood stage?
Graft requirements range from 800-1,500 at Norwood 2 up to 5,500-7,500 at Norwood 7. The exact number depends on your donor area density, hair caliber, and coverage goals.