Male Hair Loss Scale

How Do Hair Transplant Clinics Classify Patients?

You might be curious about how hair transplant clinics categorize their patients. There are two internationally recognized classification systems that help determine the stage of hair loss in patients and the best approach to treatment. Male and female hair loss occurs due to different reasons, so we use two separate scales depending on gender. Since no two people are exactly the same, no two scalps are identical either. However, this post serves as a helpful guide for those who want to assess their hair loss at home and determine which category they might fall into.

Male Pattern Baldness – The Norwood Scale

Hair loss affects both men and women, but based on our experience, male pattern baldness is the most common form. In 1975, Dr. O’Tar Norwood developed the most widely used classification system for this type of hair loss. For a patient to be classified using the Norwood scale, they must first be diagnosed with androgenetic alopecia, also known as male pattern baldness. If hair loss is due to other factors—such as poor nutrition or medical conditions—it cannot be categorized using this scale.

The Norwood scale identifies two primary patterns of hair loss:

• The standard Norwood pattern
• The Norwood A pattern

There is also a third, less common category called diffuse pattern alopecia, but since it is rare, we will not cover it in this article.

The Standard Norwood Pattern

The most common pattern of male hair loss begins in two areas:

• The temples, where the hairline starts receding.
• The vertex (crown), the area on the top of the head where hair often begins thinning early.

Over time, these areas expand and merge, eventually leaving the entire front, top, and crown of the scalp bald.

The Stages of the Norwood Scale

• Norwood I. The adolescent hairline, where hair naturally sits at the upper forehead without any signs of baldness.
• Norwood II: The mature hairline, where slight recession occurs in the corners of the forehead, forming small triangular areas. This is a normal part of aging and does not indicate baldness.
• Norwood III: The earliest stage of hair loss, where the hair at the temples recedes further, and thinning begins at the crown. Early-stage Norwood III hair loss can often be treated with non-surgical therapies or hair transplantation, especially in younger patients.
• Norwood IV: More significant hair loss at the crown, with increased recession at the front. However, a band of hair still separates the bald areas.
• Norwood V:The dividing band of hair begins to thin, and the bald areas continue expanding.
• Norwood VI: The bridge of hair between the front and crown disappears, leaving one large bald area from the forehead to the crown.
• Norwood VII: The most advanced stage, where only a “horseshoe” pattern of hair remains on the sides and back of the head. This area is more resistant to DHT, the hormone responsible for hair loss.

The Norwood A Pattern

The Norwood A pattern follows a different progression. In this case, hair loss moves from front to back, creating a continuous area of baldness rather than separate thinning zones. In Norwood A cases, hair loss at the crown is typically less extensive, but the frontal recession is more severe, making the patient appear balder. Because the front hairline plays a crucial role in facial appearance, patients with Norwood A pattern hair loss often seek surgical hair restoration earlier. 

This is because:

• The front hairline is less responsive to medication compared to the crown.
• The strong hair on the sides and back creates a high contrast with the bald area, making the hair loss more noticeable.

If you have any questions about the classification of hair loss or hair transplantation, feel free to contact us by clicking the button below!