The Norwood Scale Explained: What Stage of Baldness Are You In?

1. What is the Norwood Scale?

The Norwood scale (in full: the Hamilton-Norwood scale) was developed in the 1950s by Dr. James Hamilton and later refined by Dr. O'Tar Norwood. It is a visual classification of male hereditary baldness in seven stages, from minimal hairline retraction to complete baldness.

The scale is not perfect, there are variations and intermediate forms, but it is the most used and recognized system for describing hair loss and measuring progress.

2. The 7 stages explained

Stage 1: No visible hair loss Your hairline is completely intact. No treatment necessary, but if you have a family history of baldness, you can think preventively.

Stage 2: Minor hairline retraction Slight retreat above the temples. Many men barely notice this or attribute it to “always been like this”. However, now is the time to take action if you want to keep her.

Stage 3: Clear inlets The hairline retracts deeper at the temples, creating distinct M-shaped inlets. This is the first stage that most physicians consider “clinically significant.” Treatment here is highly effective.

Stage 3 Vertex: Crown baldness In addition to the coves, there is also loss on the crown. The classic combination of coves and balding crown.

Stage 4: Deep coves + balding crown The coves and the crown are both clearly present, but there is still a bridge of hers between them. The hair on the sides and back is still intact.

Stage 5: The bridge is dwindling The hair strip between the coves and the crown becomes narrow. Treatment still makes sense, but getting hair back in the bald areas is becoming more difficult.

Stage 6: Inlets and crown have merged There is no hair left between the coves and the crown. The baldness extends over the entire upper part of the head.

Stage 7: Just a ring of hair Only the sides and back of the head still have hair, the classic “wreath” around a bald head.

3. How do you use the Norwood Scale?

You can make a reasonable estimate of your stage yourself by:

1. View your head from above (use two mirrors or take a photo)
2. Assessing your hairline: are there any coves? How deep?
3. Looking at your crown: is there any thinning or no hair?
4. Comparable with Norwood scale images

Keep in mind that your stage isn't always easy to determine, especially if you're in a transition zone. A doctor or dermatologist can provide a more accurate assessment.

4. What your stage means for treatment

The earlier you get in the scale, the more effective the treatment usually is:

• Stage 1—2: Preventive treatment has the most impact. Finasteride can stop the progression almost completely.
• Stage 3—4: Treatment is highly effective. Finasteride and/or minoxidil can stop hair loss and, in many cases, also repair the hair on the crown.
• Stage 5—6: Treatment may stop progression, but getting hair back in completely bald areas is unlikely. A hair transplant may be considered.
• Stage 7: Medication has little effect on bald areas anymore. A hair transplant may be an option.

This once again highlights how important it is to take early action. Learn more about the effective treatments: Finasteride against hair loss and Minoxidil hair loss pills.

5. Norwood scale in women: the Ludwig scale

A different classification system is used for women: the Ludwig scale. This has three stages (I, II, and III) and describes the thinning of the hair at the crown while keeping the hairline intact. The Ludwig scale is more in line with the typical pattern of female hereditary baldness (FPHL).

At 3CO, our BIG-registered doctors will personally assess your hair loss and recommend the best treatment for your specific stage. Start your free consultation.