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What to know about the Norwood scale and male pattern baldness

The Norwood Scale helps to rate male pattern baldness stages on a scale of 1 to 7. Individuals with male pattern baldness tend to lose hair in one of a variety of specific ways, and the Norwood scale also helps to define the development of these hair loss trends.

Understanding this can enable doctors to make a specific diagnosis and identify the best treatment options for each person. While they tend to be identical to the Norwood scale, some doctors can use their own scales.

Continue reading to learn more about the Norwood scale levels, certain male pattern baldness remedies and advice on hair health and how to cope with hair loss.

Stages of the Norwood scale

In the 1950s, James Hamilton introduced a scale for calculating the phases of male pattern baldness. The scale was then significantly improved in the 1970s by Dr. O’Tar Norwood.

The Norwood scale describes seven stages of baldness for each form of baldness, with specific models. Each stage has a normal pattern, and a pattern for class A.

The normal pattern appears to begin with a bald spot above the eye. Class A balding has a distinct pattern, so instead the hairline slides from the front to the back.

Stage 1

The control stage is Stage 1 of the Norwood scale. People in male pattern baldness stage 1 still have a full head of hair, with little to no signs of baldness or hairline receding.

Stage 2

There is only slight evidence of a receding hairline in Stage 2, generally around the temples.

Stage 3

The hair loss generally begins to become noticeable during stage 3. Typically the hairline pulls back from the temples, giving it a curved “M” shape when seen from above.

The dips in the hairline may be slightly less specified in Class A variant of the scale, or stage 3A.

Stage 3 vertex

Stage 3 vertex balding is a less drastic version of stage 3, in terms of the receding hairline.

However, people who experience balding in the vertex of stage 3 will also start losing hair on their head’s crown. This often begins as one tiny bald spot.

Stage 4

Important hair loss occurs by stage 4. The hairline recedes further, and when viewed from above, can start to resemble a “U” shape.

The bald spot on the crown is larger but between the bald spot and the receding hairline there is still a patch of hair.

A person will not encounter a bald spot on the back of their head in stage 4A, but instead will lose the dips in their hairline and have a deeper “U” shape when viewed from above.

Stage 5

Stage 5 shows progress similar to Stage 4 but is more severe. A small section of hair remains between the receding hairline and the balding crown. This strip of hair, however, is much thinner than at the previous stage.

The hairline in stage 5A continues to advance towards the back of the head.

Step 6

Someone with step 6 baldness is now predominantly bald on their forehead and top. Now the two bald areas are coming together, and there are no streaks or hair lines between them.

The sides of the head may still have hair, but the crown and front of the head are mostly bald now.

Stage 7

The baldness also starts to affect the sides of the head by stage 7, until only a small ring of hair encircles the outside of the head.

The growing hairs are likely to be very slender and thin.

Treatments for hair loss

Several solutions are available for baldness in male trends. Most treatment options have the highest rate of success when the hair loss enters its earliest stages.

Those who start treating hair loss at their later stages can only benefit from some of the more powerful treatment options, such as surgery.

The following sections list some of the hair-loss treatment options available.


Minoxidil (Rogaine) is a drug that can be applied directly to the scalp by the patient. It is available in the form of a foam and a liquid solution, making it relatively easy to apply. Minoxidil can help thicken the hair on the scalp and promote hair growth.

It may take some time for the findings to become clear though. However, the American Academy of Dermatology reports that findings may not surface until 3-6 months after the drug has been used.

Laser therapy

At-home Laser treatments come in the form in different devices producing laser light. Such tools activate the hair follicles to make healthy hair grow.

There is however no clinical evidence to support their effectiveness in the treatment of baldness of male types.


Finasteride (Propecia) is a prescription drug which is prescribed by physicians for severe hair loss. It was approved by the Food and Drug Administration (FDA) for hair loss.

Dermatological procedures

Many medical procedures can remove hairs or modify the scalp to reduce the appearance of baldness itself. The choices offered are as follows:

Scalp pigmentation

Covering the bald areas with tiny tattoos can help to create hair appearance in the region. With very short, buzzed haircuts, that works best.

Hair transplantation

The surgeon extracts small patches of healthy hair follicles from the scalp during this operation and implants them into balding areas to reduce the appearance of baldness.


Microneedling uses a tool that incorporates hundreds of small needles to penetrate the skin and stimulate the growth of hair. It’s best to work directly with a dermatologist to decide whether microneedling will be effective or not.

There has also been some research into including platelet-rich plasma in the procedure of microneedling to further improve hair growth.

Scalp expansion

During this operation, a doctor implants small devices under the scalp that will remain in place for a few weeks to expand the skin and reduce the appearance of a receding hairline or bald spots.

Scalp reduction

A doctor may recommend that parts of the scalp that have no hair on them be removed surgically, bringing closer together the areas that have hair on them.

To make the process easier, they can prescribe a scalp expansion procedure beforehand.

Tips for healthy hair growth

Aside from the procedures and medications listed above, there are a number of things a person can do to promote healthy hair growth, including:

  • Eating a healthful diet: Eating a healthful diet that includes a wide variety of vegetables, fruits, and iron-rich foods ensures that the body gets all the nutrients it needs to create healthy hair.
  • Using a hair loss shampoo: Some shampoos contain ingredients designed to help remove dandruff and other particles from the pores. This may help keep the pores clear and prevent blockages that could influence hair loss.
  • Massaging the scalp: Massaging the scalp regularly may increase blood circulation in the area, helping keep the follicles healthy. This may also help clear away dandruff and prevent blockages.
  • Stopping smoking: An older study suggests that there could be a link between smoking and hair loss.
  • Avoiding coloring or treating the hair with chemicals: Chemicals may make the hair weaker and more prone to breakage and thinning.

Coping with hair loss

Although many people are finding ways to treat mild forms of baldness, it is likely to grow with age.

How a person chooses to deal with a hair loss is their responsibility. Others make adjustments to their care to keep their hairs healthy for as long as possible. Even so, treatment options may not be as effective as the person grows older and their hair becomes weaker and thinner.

Others may opt for more permanent options, including hair transplants. Some people may decide to wear pieces of hair or headgear to cover up their baldness.

Some choose to shave their heads entirely, rather than seek treatment.

It is important to remember that baldness of the male pattern is a natural part of aging and not something about which to be embarrassed or ashamed.


Balding and hair loss are very common, especially as people are getting older.

Knowing the severity of Norwood and what level of male pattern baldness a person is at will help them collaborate with doctors to figure out the best treatment options.

A variety of treatment options are available to help treat baldness in male populations, and the results of each can vary from person to person.

Chukwuebuka Martins

Chukwuebuka Martins is a writer, researcher, and health enthusiast who specializes in human physiology. He takes great pleasure in penning informative articles on many aspects of physical wellness, which he then thoroughly enjoys sharing to the general public.

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