What are the Stages of Hair Loss? – The Norwood Scale

Are you or someone close to you suffering from hair loss? Do you know which stage you are at?

The Norwood Scale defines hair loss in seven stages. The Scale is used as a reference point to determine the extent of baldness, and this informs the correct treatment option. The scale is also used to help plan how many grafts a patient may require in order for them to achieve coverage of hair following a hair transplant surgery.

stages of hair loss

  • Stage 1: No significant hair loss or recession of the hairline

People in the first stage still have a full head of hair, with little to no signs of baldness or a receding hairline.

  • Stage 2: There is a slight recession of the hairline around the temples. This is also known as an adult or mature hairline
  • Stage 3: The first signs of clinically significant balding appear. The hairline becomes deeply recessed at both temples, resembling an M, U, or V shape. The recessed spots are completely bare or sparsely covered in hair

Generally in this stage, hair loss starts to become noticeable. The hairline typically pulls backward from the temples, giving it a curved “M” shape when viewed from above.

  • Stage 3 vertex: The hairline stays at stage 2, but there is significant hair loss on the top of the scalp (the vertex)

In terms of the receding hairline, stage 3 vertex balding is a less drastic version of stage 3. However, people experiencing stage 3 vertex balding will also begin losing hair on the crown of their heads. This often starts as one small bald spot.

  • Stage 4: The hairline recession is more severe than in stage 2, and there is sparse hair or no hair on the vertex. The two areas of hair loss are separated by a band of hair that connects to the hair remaining on the sides of the scalp.

The hairline recedes farther and may start to resemble a “U” shape when viewed from above. The bald spot on the crown is larger, but there is still a strip of hair between the bald spot and the receding hairline.

  • Stage 5: The two areas of hair loss are larger than in stage 4. This stage shows a similar progression to stage 4 but is more severe. There is still a small section of hair between the receding hairline and the balding crown. However, this strip of hair is much thinner than in the previous stage.
  • Stage 6: The balding areas at the temples join with the balding area at the vertex.

Someone with stage 6 baldness is now mostly bald on the front and top of their head. The two bald areas now join together, and there is no strip or patch of hair between them.

There may still be hair on the sides of the head, but the crown and front of the head are now mostly bald.

  • Stage 7: The most severe stage of hair loss, only a band of hair going around the sides of the head remains.

At this point, the baldness also begins to affect the sides of the head, until only a thin ring of hair encircles the outside of the head. The hairs that grow are likely to be very thin and weak.

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