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Baldness evolution with the Norwood scale: best to know!

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How to measure baldness evolution with the Norwood scale? Is it an excellent tool to know if it is possible to undergo a hair transplant?

Baldness evolution with the Norwood scale

How to measure baldness evolution with the Norwood scale? the seven steps!

Since the 1950s, doctors have used the Norwood scale to measure baldness stages. This scale is helpful in treatment planning and to see if hair loss prevention drugs are efficient.

Genetics and male hormones: the main factors of male baldness

In the 1950s, the anatomist James B. Hamilton observed baldness patterns on prisoners and designed a scale to measure it. He was sure that genetics and male hormones played a crucial role in hair loss apparition and evolution in males. The Norwood-Hamilton scale counts seven stages.

The seven stages of the Norwood scale

  • Stage one: the baldness began. A very light thinning appears on the front line and the temples. There is no hair loss yet.
  • Stage two: Thinning on the front line and temples continues and starts on the vertex (top of the head).
  • Stage three: the temples area becomes bald, the hairline has receded. A bald spot appears on the vertex (top of the head). The patient may take supplements to slow hair loss, as nutrient deficiency may fasten hair loss. To hide the damages, he can use hair powder. A hair transplant is also a solution, but the patient must keep in mind his baldness will keep evolving.
  •  Stage four: massive hair loss on the temple, and it aims to join the bald spot of the vertex.
  • Stage five: little change compared to the previous step; the bald spots from the temples and the vertex become closer. The advanced baldness of the frontline gives a bald appearance to the head.
  • Stage six: the bald spot from the temples and the vertex finally make only one big bald spot going from the forehead to the back of the head.
  • Stage seven: the baldness is complete. The remaining hair on the scalp is resistant to male hormones. Only the hair on the side and the back of the head remains.

Baldness evolution with the Norwood scale: is there a point it is too late to undergo a hair transplant?

Many patients wonder if it is still possible to undergo a hair transplant on the latest stages of the Norwood scale. There is no universal answer to this question, as the doability of a hair transplant depends on several things. First, to do a hair transplant, the patient must have enough hair in the donor area, in the back of the head. A poor donor area would make the procedure undoable.

In other words, someone with advanced baldness on the top of the head but a high-quality donor area can do a hair transplant. On the contrary, someone with less advanced baldness and a poor donor area would not be eligible for a hair transplant.

On the opposite, patients doing hair transplants at the early baldness stages have to know the surgery will not stop their hair loss, and they may need another surgery in the following years.