The Norwood Scale, which describes the seven stages of balding, has become the accepted standard for measuring male-pattern baldness. While everyone’s hair loss experience is different, the patterns defined by the scale can help you predict your future hair loss and how many grafts you might need to restore your hair. Determining which stage you are in can also help you decide on a hair restoration solution that is right for you.
History of the Scale
Dr. James Hamilton, who was the first to classify male-pattern baldness in stages, originally created the Norwood Scale in the 1950s. In 1975, O’Tar Norwood revised it by adding the Type III A, Type III Vertex, Type IV A and Type V A categories. For this reason, the scale is sometimes called the Hamilton-Norwood scale.
Why Use the Norwood Scale?
Determining your stage of baldness can help you predict future hair loss and decide on the right treatment plan. The earlier you reach Type III, for example, the more likely you are to advance further on the scale. (The higher the stage, the more extensive the hair loss.) It also serves as a guide to estimate the number of grafts you will need during your hair restoration treatment.
Seven Stages of Baldness
Type I indicates little to no hair loss. It is sometimes called the “juvenile hair line” because it resembles the hairline of a very young person. Only about 5 percent of men stay in this stage throughout their lifetime.
Type II is sometimes considered natural hairline recession. It is not severe enough to seek treatment. It is classified as hair that has receded by about half an inch. This loss is usually around the temples.
Type II A
The “A” in Type II A stands for "anterior." This means more hair is lost from the anterior, or front, of the head. The amount of hair loss is very similar to Type II, but is more noticeable at the top of the forehead.
Type III is the most common stage of balding for men. This is the first stage where you might consider treatment for hair loss. This receding hairline can take many shapes — M, U or V shapes are common. This level of hair loss is very treatable.
Type III Vertex
Someone can be classified as being in the Type III Vertex stage of male-pattern baldness if they have noticed loss of hair from the vertex, or back, of the head.
Type III A
Type III A is similar to Type III hair loss, but the receding hairline is further back toward the top of the head.
Type IV is classified by more significant hair loss from both the hairline and vertex. While these areas have thinned in this stage, they are not yet completely bald.
Type IV A
The hairline of men with Type IV A hair loss has receded about halfway back on the head. They do not have significant hair loss around the vertex.
Type V hair loss is represented by hair loss from the anterior and vertex of the head. Someone in this stage still has a “bridge” of hair between the two major areas of hair loss.
Type V Vertex
Type V Vertex hair loss is defined by a significant loss of hair from the back of the head. In this stage, there is still a small amount of hair acting as a “bridge” between the anterior and vertex of the head.
Type V A
Those with Type V A hair loss have lost hair from the forehead past the midpoint of the scalp. They do not have significant hair loss at the vertex.
People with Type VI hair loss have lost the “bridge” between the anterior and vertex of the head, meaning they have little to no hair from the forehead to the back of the head. Hair still exists around the sides and back of the head.
This is the most severe stage of male-pattern baldness and the most difficult to treat. The hair that is left typically appears in a horseshoe shape that goes from the sides around the back of the head.
Using the Scale to Estimate Your Grafts
Once you determine which stage of the Norwood Scale you are in, you can estimate how many grafts will be needed to restore your hair. You can multiply your stage number by 1,000 to receive a rough estimate or use an online calculator to get a better idea. Keep in mind that these estimates don't factor in the fullness you are trying to achieve with your hair restoration treatment.
No online test or calculation can replace a consultation with your dermatologist. If hair loss is causing you stress, talk with a board-certified dermatologist about hair restoration. After learning more about your family history and lifestyle, a doctor can help you determine the best treatment option for you. Contact Dallas NeoGraft today to schedule a consultation.