Norwood Scale

The Norwood scale is the standard seven-stage description of male pattern hair loss, from an intact juvenile hairline to the horseshoe of donor hair alone.

Where you'll meet it

In every quote and consultation, and on every forum. Clinics use it to describe cases and to organise their before-and-after galleries, and you will often see it shortened to NW, as in "a NW3 with a thinning crown". It is sometimes called the Hamilton-Norwood scale after the two people who developed it.

What do the stages mean?

Stage 1 is the juvenile hairline, low and fairly straight. Stage 2 is the mature hairline most men settle into in their twenties: a slight rise and shallow recession at the corners, which is not hair loss. Stage 3 is the first genuine loss, with deeper recession at the temples; a "3 vertex" adds early thinning at the crown. Stage 4 has clear frontal recession and a thinning crown with a band of hair still between them. At stages 5 and 6 that band narrows and then goes, so the front and crown join. Stage 7 leaves only the horseshoe at the back and sides, often thinner than it once was.

There are also "A" variants, where the loss moves back from the front as one front-to-back recession rather than as two separate areas. They are less common and change the planning, because the front is lost first and there is no crown to leave alone.

Does the scale work for women?

Not well. Women's pattern loss usually spreads as diffuse thinning over the top while the hairline stays put, and it is described with different scales, most often Ludwig or Savin. If a clinic grades a woman's loss on the Norwood scale, that tells you something about how much experience they have with it.

What is its real limitation?

It describes today. What matters for planning is the stage you will finish at, and the scale says nothing about that. Two men who are both stage 3 at twenty-five can end up at stage 4 and stage 7, and the right transplant for each is completely different.

Family history on both sides and the age your loss started are the better guides. Loss that starts early tends to go further. A surgeon planning your hairline against your current stage rather than your likely final one is planning an island: transplanted hair at the front with a gap opening up behind it.

How should you use it?

As shared vocabulary, not a verdict. It lets you describe where you are in a sentence and compare yourself with gallery cases that started in a similar place, which is the only fair comparison. When you look at results, look for your stage, and ideally for cases a few years older than you, so you can see what the plan looked like once the loss had moved on.

At a consultation, the useful question is not "what stage am I?" but "what stage do you think I will end up at, and how does this plan allow for it?" Norwood stage and what it means goes through what each stage means for surgery.

← Back to the Glossary