Norwood Stage

By Nick Peplow·Founder and editor

Last reviewed 12 October 2026· How this site is researched

The Norwood scale is the standard way of describing male pattern hair loss, running from stage one, an untouched juvenile hairline, to stage seven, where only the horseshoe at the back and sides remains. Every clinic uses it, and every quote you receive will reference it.

It is a description, not a prediction. Its usefulness in a consultation is that it gives you and the surgeon a shared vocabulary for where you are now and, more importantly, an honest conversation about where you are going.

The stages in plain terms

Stage 1 is the juvenile hairline, low and straight. Stage 2 is the mature hairline that replaces it in most men somewhere in their twenties: a slight rise and shallow recession at the corners. That is not hair loss and does not need treating.

Stage 3 is the first genuine loss, with deeper temporal recession. Stage 3 vertex adds thinning at the crown.

Stage 4 has significant frontal recession and a crown area that is visibly thinning, with a band of hair still separating the two.

Stage 5 sees that band narrowing. Stage 6 is where it goes, and the front and crown join into one area.

Stage 7 leaves only the horseshoe, and the donor area itself is often reduced.

The variants the basic scale misses

Some stages have an "A" variant, where the loss moves backwards from the front as a single receding front rather than as two temple corners with a crown patch. A Norwood 3A or 4A has no isolated crown, and the hair loss reads mainly as a high forehead. These patterns are often good transplant candidates, because the front is where grafts do the most visible work and there is no crown competing for them.

Not everyone fits the scale at all. Diffuse thinning across the top, without a clear receding edge, is common and is harder to treat surgically, because there is no bald area to put grafts into, only thinning hair to place them between. Grafting into thinning hair risks shock loss of the native hairs around it, and if those hairs are still miniaturising the result will keep thinning around the grafts.

The Ludwig and Savin scales describe the diffuse pattern typical of women, where the hairline usually holds and the parting widens. That pattern needs a different conversation, covered in hair loss in women.

Why your final stage is the number that matters

A transplant planned only for the head you have today, in someone whose pattern will continue to a stage six, can end up as an island. The grafts stay while the pattern carries on around them, which is why good plans look ahead.

So the planning question is not what stage are you, it is what stage will you finish at. Family history is the best available guide, particularly on both sides rather than just your mother's father, which is a persistent myth. Age of onset matters too: earlier loss tends to mean more extensive final loss.

A good surgeon plans the hairline and graft distribution against your likely final pattern, not your current one, and will say so. That is why they argue for conservative hairlines.

The graft arithmetic

Graft estimates by stage circulate widely online, and they are useful only as a feel for scale. They vary with the size of your head, the density you want, and the factors covered under donor supply: hairs per graft, calibre, curl and contrast.

As a rough shape rather than a quote, a stage 3 hairline and temple restoration tends to sit in the low thousands of grafts. A stage 4 or 5 front and mid-scalp tends to need more, often a large session or two. Treating stages 5 and 6 front to back at a convincing density can call for more grafts than many people have in total.

That comparison is the whole point. Set the area you might eventually need to cover against the lifetime supply you have. If the two numbers are close, or the area is bigger, the plan has to prioritise, and the front almost always wins.

It also explains why the same person can get wildly different quotes. One clinic is quoting for today's stage, another is quoting for the head you will have at fifty. The second is usually the one that serves you better over time. There is more on that in why quotes never match.

What each stage means for surgery

Stages 3 and 4 are the classic transplant territory: enough loss to be worth treating, enough donor to treat it, and a pattern with a defined edge.

Stage 5 and 6 need careful arithmetic. The area needing coverage may exceed what donor supply can reasonably cover at a convincing density, and the honest plan is often to treat the front well and leave the crown, or to combine a smaller transplant with scalp micropigmentation.

Stage 7 is rarely a good candidate for a conventional transplant, because the donor horseshoe is both small and often thinned.

At any stage, unstabilised loss in someone under thirty is a reason to wait and to get on medication first.

How the stage shapes the plan

At stages 2 to 3, the main questions are whether this is loss at all and whether medication can hold it. A mature hairline is not a problem to fix, and transplanting into a stage 2 to recreate a teenage line spends grafts on a shape you will probably outgrow. If there is real temple recession, the temples page covers what can be done.

At stages 3 to 4, the plan usually centres on the hairline and frontal third, designed to look right if the crown later thins. A surgeon should be able to show you how the hairline would sit at stage 5 or 6 as well as now.

At stages 5 to 6, the plan is about choosing. Most people get the best value from a strong front, a lighter mid-scalp, and the crown left alone or treated later with whatever remains. Some choose a mature, higher hairline so the grafts go further.

At stage 7, the conversation is often about alternatives, including micropigmentation, a well-cut short style, or a small, frontal-only transplant where the donor allows.

Asking about your stage

When a surgeon tells you your stage, ask two follow-up questions. Where do they expect you to end up, and why do they think that? Then ask how their plan would look if they are wrong by one stage in the bad direction.

I would pay more attention to the answer to that second question than to almost anything else said in a consultation. It shows whether the plan has room for the future or only works if the future is kind. The consultation guide covers the rest of what to bring and ask.

None of this replaces an examination. Your surgeon is the one who can stage your loss properly and judge what is realistic.