The Norwood Scale: Hair Loss Stages, & Treatments

Male  Pattern Baldness Hardboiled Egg
Kristin Hall, FNP
Medically reviewed by Kristin Hall, FNP Written by Our Editorial Team Last updated 8/25/2020

Does your hairline seem thinner than before? You’re not alone. Male pattern baldness is a very common condition that affects men of all ages, with more than 50 percent of men experiencing some degree of hair loss by the age of fifty.

Unfortunately, a lot of men affected by male pattern baldness fail to take notice of the first signs of hair loss. The result of this is that many men lose far more hair than they need to before they seek out treatment.

If you’re concerned about a receding hairline, or you’ve noticed that your hair is thinning around the crown of your head, it’s important to keep track of any changes in your hair. 

Luckily, there’s a system that can help you do that. Developed in the 1950s by James Hamilton and updated in the 1970s by O'Tar Norwood, the Hamilton-Norwood scale (or just the Norwood scale, as it’s more commonly known) is a system used to track the stages of hair loss in men. 

The Norwood Scale sorts hair loss into seven different types, from a slight receding hairline to almost total baldness across the scalp. Although the scale isn’t perfect, it’s a useful way to keep track of your hair and monitor any changes in your hairline.

Below, we’ve explained how the Norwood Scale works. We’ve also explained how you can use the scale to keep track of your hairline and hair thickness over time and, if necessary, decide if it’s time to take action to protect and restore your hair. 

What Is the Norwood Scale?

The Norwood Scale is a seven-type scale that’s used to measure and categorize the different stages of male pattern baldness.

Men affected by male pattern baldness typically don’t lose hair evenly from across their entire scalp. Instead, most hair loss caused by male pattern baldness follows a specific pattern that begins in a specific area. 

For example, many men first notice the signs of hair loss when their hairline begins to recede around the temples. This is known as Type 2 hair loss on the Norwood Scale, or a mature or adult hairline.

Other men develop a receding hairline accompanied by a small bald patch on the scalp. This is classed as Type 3 vertex hair loss using the Norwood Scale.

The Norwood scale is commonly used by healthcare professionals that specialize in diagnosing and treating hair loss in men. 

Although it’s not perfect (we’ll cover its weaknesses a little further down the page), it provides a useful system for classifying and measuring the extent of a man’s hair loss. 

What Does Hair Loss Look like per the Norwood Scale?

Does the Norwood Scale sound a little confusing? We put together a visual guide to help you understand just what to look for when you look in the mirror. We'll go into each of the seven Norwood Scale types below, but in the meantime:

Norwood Scale Graphic

How Does the Norwood Scale Work?

As we mentioned above, the Norwood Scale is made up of seven numbered types. Some types may be accompanied by additional information, such as hair loss on the vertex of the scalp.

The higher the number is on the Norwood Scale, the more advanced the man’s hair loss is. The types are as follows:

Norwood Type 1

Men with a hair loss pattern that’s classified as Type 1 on the Norwood Scale have no minimal or no recession of the hairline, with no visible loss of hair to the crown.

Many men have a Norwood Type 1 pattern before experiencing some level of hair loss as they age. Although it’s uncommon, some men maintain a Norwood Type 1 hair pattern for their entire lives. 

Norwood Type 2

Men with hair that’s classified as Norwood Type 2 display slight recession of the hairline at the temples, with no hair loss at the vertex of the scalp. At this stage, the early signs of the common M-, V- or U-shaped hairline begin to appear.

Although a Norwood Type 2 hairline can precede more hair loss, not all men with this hair loss pattern continue to lose hair as they get older. 

Norwood Type 3

Men with hair that’s classified as Norwood Type 3 have visible, obvious hair loss at the temples and the frontal area of the scalp. At this stage, the M-, V- or U-shaped hairline that commonly develops in men affected by male pattern baldness is pronounced and easy to see. 

Some men with a Norwood Type 3 hairline also experience hair loss at the crown, or vertex. This is referred to as Norwood Type 3 vertex hair loss. Men with more significant hair loss around the frontal area of the scalp may be classified as having a Norwood Type 3 A hair loss pattern.

Norwood Type 4

By the time a man’s hair loss progresses to Norwood Type 4, loss of hair is obvious across the front of the scalp, the temples and the crown. Men with Norwood Type 4 hair loss often have a small band of hair that runs across the scalp, separating the two areas affected by hair loss. 

Norwood Type 5

Men with hair that’s classified as Norwood Type 5 display significant, obvious hair loss around the front of the scalp, the temples and the crown. The hair loss is greater than in Type 4, with noticeable thinning of the band of hair that separates the forehead and crown. 

For many men affected by male pattern baldness, this is when the classic horseshoe pattern of hair loss becomes more visible.

Norwood Type 6

Men with hair that’s classified as Norwood Type 6 have significant hair loss at the front of the scalp, the temples and the crown. The two areas of hair loss are joined, with either thinning or total loss of hair on the small band that previously separated the forehead and crown.

Norwood Type 7

Men with hair that’s classified as Norwood Type 7 have the most severe, significant hair loss from male pattern baldness. At this stage, the front of the scalp, temples and crown no longer have any significant amount of hair, with only the horseshoe pattern of hair remaining. 

How to Use the Norwood Scale to Track Hair Loss

Your first move should be making an appointment with a certified dermatologist or healthcare professional that specializes in hair loss.

But, if you'd rather monitor the situation yourself before calling in the heavy artillery, here're a few useful tips:

To start tracking your hair loss, take a series of reference photos of your hair. You can use these as a visual baseline to see if there are any changes in your hairline over the next few months or years.

Take one photo of your hairline. You can do this easily with the selfie camera on your phone, or by taking a photo in the bathroom mirror. Make sure your face and hairline are well lit, as it can be hard to difficult your hairline clearly in a poorly lit or underexposed photo. 

To get a good view of your hairline, tilt your head forward slightly so that your hairline and the top of your head are both clearly visible. This photo should show any change in your hairline from the front. 

Next, take a photo of your face profile (the side view of your face). You can do this by putting your smartphone on a shelf and using the self timer to take a photo of yourself. This will show any change in your hairline around the temples.

Next, take a photo of the top of your head. You can do this by holding your smartphone above you using a selfie stick, then using the front camera, or by asking another person to take your photo. This will show any hair loss on your scalp and crown. 

Finally, take a photo of the back of your head. You can do this using a selfie stick, or by asking someone else to take your photo. This will provide a clear view of any hair loss at the crown, or vertex, of your scalp. 

Using your photos, compare your hair to one of the Norwood types. Every two to three months, take a new set of photos and check for any changes. To make sure you keep regular photos of your hair, you can set a reminder for every other month using your phone calendar. 

If your hair has advanced from one stage to the next, it’s a good signal that you’re losing your hair and should think about taking action. 

When Should You Take Action to Protect Your Hair?

The earlier you take action to treat and prevent hair loss from male pattern baldness, the more of your hair you’ll usually be able to keep using treatments like finasteride and minoxidil.

If you notice your hair advancing from one Norwood type to the next, or if you notice any of the other common early signs of male pattern baldness, take action as soon as possible. If you treat your hair loss while you’re still Type 2 or 3, you may be able to keep most or all of your hair. 

As hair loss progresses to the later stages, it becomes more difficult to treat effectively, even via surgical procedures such as hair transplantation

Options for Treating and Preventing Hair Loss

The most effective treatments for male pattern baldness are finasteride and minoxidil. Each of these treatments targets hair loss from a different angle, helping you to maintain your hairline and potentially regrow hair in affected areas.

Finasteride

Finasteride is an oral medication. It works by preventing testosterone from converting into DHT, the androgen hormone believed to cause or contribute to hair loss in men. With lower levels of DHT, your hair follicles are less likely to suffer from the hormonal damage that causes hair loss.

Studies of finasteride show that it works, with approximately 83 percent of men who used it in clinical trials experiencing no new hair loss and 66 percent of men actually growing back hair in some areas of the scalp after using it regularly or two years. 

Finasteride is a prescription medication, meaning you’ll need to talk to a healthcare provider  before you can purchase and use it. We offer finasteride online, subject to approval  after a consultation with a licensed healthcare provider. 

Minoxidil

Minoxidil is a topical medication that you apply to your scalp. It increases blood flow to the hair follicles, stimulating growth and helping you to maintain the growth of hair in areas of your scalp affected by male pattern baldness.

Unlike finasteride, minoxidil doesn’t block DHT. Minoxidil is commonly used in conjunction with finasteride for better results. 

A 2018 study involving 40 patients between the ages of 18 and 60 years old found at the end of 24 weeks that those treated with a finasteride and minoxidil mix experienced “significantly superior” results than those treated with just minoxidil. Ninety percent treated with minoxidil and finasteride saw a moderate to marked improvement.

Minoxidil is not a prescription medication, meaning you can purchase it without seeing a healthcare provider first. We offer minoxidil online with discreet, convenient delivery to your address, both on its own and as part of our as part of our Hair Power Pack

Other Hair Loss Treatments

If your hairline is starting to recede or you have a more advanced form of baldness, finasteride and minoxidil are the two most effective treatment options available. As such, they’re generally recommended as first-line therapies.

However, a variety of other products are available that may be able to improve hair growth and produce some improvements in your hairline. 

These include shampoos containing ketoconazole, which may be able to disrupt DHT locally in the scalp and prevent some amount of hair loss. Certain vitamins and minerals while not directly preventing androgenic hair loss, are also linked to healthy hair growth. 

In Conclusion

If you think you’re losing your hair and want to stop it, it’s important to take action as soon as possible. The earlier you start using treatments such as finasteride and minoxidil, the more of your hair you’ll likely be able to maintain and protect.

To monitor your hair loss, follow the photography instructions above and compare your hair to each stage on the Norwood Scale. If you notice that your hairline or crown is progressing from one stage to the next, consider taking action to stop baldness and maintain your hair. 

Learn More About Male Pattern Baldness

Male pattern baldness is an extremely common condition, affecting more than 50 percent of men by the age of fifty. Learn more about the causes of male pattern baldness and what you can do to prevent hair loss in our male pattern baldness overview

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.