The Norwood scale (also called the Hamilton-Norwood scale) is the standard classification system for male androgenetic alopecia. Understanding where you fall on this scale is a fundamental part of planning a hair transplant and predicting future hair loss.
The Norwood Stages
Norwood 1: Minimal hairline recession. Considered normal for most adult males. Not a candidate for hair transplant.
Norwood 2: Slight temples recession. Minor but visible hairline movement. Hair transplant not typically needed at this stage.
Norwood 3: Clear temple recession forming an M-shaped hairline. This is usually when patients first seriously consider treatment. Norwood 3 vertex adds thinning at the crown.
Norwood 4: More significant recession at the temples and thinning at the crown, with a solid bridge of hair between. Two distinct areas of loss becoming apparent.
Norwood 5: The band of hair between temples and crown begins to thin significantly. The two loss areas are still separate but the connecting strip is narrow.
Norwood 6: The band between temples and crown is gone or very sparse. The two loss areas have merged. Extensive balding across the top of the scalp.
Norwood 7: The most severe stage. Only a narrow horseshoe-shaped band of hair remains at the sides and back. Everything on top is bald.
How the Norwood Scale Guides Hair Transplant Planning
Graft requirements by stage:
- Norwood 3: 1,500–2,500 grafts for hairline restoration
- Norwood 4: 2,500–3,500 grafts for hairline and front scalp coverage
- Norwood 5: 3,000–4,500 grafts for hairline, front, and partial crown
- Norwood 6–7: 4,000–6,000+ grafts across multiple sessions for comprehensive coverage
Future loss prediction: A 25-year-old at Norwood 3 may progress to Norwood 5 or 6 by age 50. Planning must account for this progression — preserving enough donor supply for future sessions.
The Importance of Family History
Family history is the best predictor of eventual Norwood stage. Looking at paternal grandfather, maternal grandfather, and father gives the most useful picture of likely long-term trajectory.
Not sure which Norwood stage you are at or how to plan? Send us photos — our team will assess your current stage, predict likely trajectory, and recommend the appropriate approach.