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The Norwood Scale

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Norwood Scale?

Also referred to as the Norwood-Hamilton Scale, it is a way to measure and estimate the severity of hair loss on a patient. There are seven different classifications which you can find out more about below.

Is It Important?

Determing how many hair grafts you'll potentially need is exteremely important. Some patients have hair loss that is too severe for a hair transplant to be effective. This is why we use the Norwood Scale to determine how many hair grafts a patient will need.

How It Is Used

Using a scale from 1-7, we can estimate how many hair grafts a patient will need. Stage one means having no hair loss while stage seven means complete hair loss (essentially bald).

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Hair Loss And The Norwood Scale?

Hair loss can creep up on you. For many people, the sudden loss or thinning of hair can be a mystery. There is usually a genetic or hereditary component, or perhaps hair loss begins as a result of medical treatment and certain medications. Whatever the cause, hair loss can surprise you even if you’re aware it’s coming. People tend to think (or rather hope) that hair loss will pass them by even as they age. Unfortunately, hair loss is incredibly common and waits for nobody. This doesn’t mean you have to accept it! Hair loss has been studied extensively, and it is no mystery to qualified professionals. There is even a way to gauge your hair loss at home that you’ve probably never heard of – the Norwood Scale.

What is the Norwood Scale?

The Norwood Scale – sometimes referred to as the Norwood-Hamilton Scale – is a way to gauge and estimate hair loss. It was introduced by a physician named James Hamilton in the 1950s, but it is best known for being updated and clarified by another physician, a man named O’Tar Norwood, a few decades later in the 1970s. The Norwood Scale is a commonly used model to classify the different stages of male pattern baldness. As you probably know, hair loss becomes more severe over time and the Norwood Scale allows professionals to judge what stage of hair loss someone has entered. 

The Norwood Scale is divided into seven different stages, with each stage having a distinctive pattern and level of severity. These varying stages are very helpful for doctors who specialize in hair loss, as it allows them to create a personalized treatment plan for each patient based on the stage of the Norwood Scale they have entered. It has been concluded that most men experience hair loss in a particular order, beginning at the temples on either side of the skull before continuing on to the crown of the head and the scalp. While special cases will always exist, hair loss for most men follows this established pattern. 

The Norwood Scale measures hair loss, going from no balding at all to being completely bald. Essentially, the further along a person is in the stages of the Norwood Scale, the more severe their hair loss. Severe hair loss also limits the options for treatment, so it is important to know a bit about the Norwood Scale yourself in order to track your hair loss. If you suspect you are moving into a later stage, it may be time to get a consultation from a professional before your treatment options become more limited. 

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What Are The Stages Of The Norwood Scale

As mentioned before, the Norwood Scale is divided into seven different stages. The beginning of the scale, Stage One, has no hair loss at all. The end of the stages, Stage Seven, would mean someone is completely bald. Now, we will cover the distinctive seven stages of the Norwood Scale.

Stage One – The beginning of the Norwood Scale.This is where most people with “normal” levels of hair and hair thickness will be located. This stage is characterized as showing no signs of hair loss or a receding hairline. This stage may also be referred to as the juvenile stage, due to the fact that most men will stay in this stage until they begin to age around their early to mid 30s. 

Stage Two – At this stage of the scale, there will be the slightest recession of the hairline. This typically starts at the temples, located on either side of the upper facial area.You may notice that hair has become less dense in the central and frontal parts of the scalp. This thinning is not hugely noticeable, but is a good sign that the hair loss process has begun.

Stage Three – This stage at the center of the Norwood Scale is where hair loss becomes more significant. The hairline will recede further, appearing to lengthen the forehead and retreating symmetrically from the temples. This can produce an “M” shape of the hairline. This stage is typically when most men begin to consider a serious treatment to cure hair loss. 

Stage Four – The differences between the previous stage and stage four can be mild, but the trademark of stage four is a deeper recession of the hairline and a prominent “M” shape along the hairline, more noticeable than the one from stage three. You will also start to notice the thinning and loss of hair on the crown of the head, perhaps near the center of the scalp. This can mark the difference between a receding hairline and definitive hair loss all across the head.

Stage Five – At this stage, the band of hair separating the receding hairline from the crown of the head becomes thin and narrow. It may even disappear completely, leaving some hair remaining at the base and back of the head but none at the temples and crown. This stage marks the beginning of the formation of the “horseshoe shape” that many people imagine with hair loss, where hair remains at the side and back of the head but the rest of the crown is bald. 

Stage Six – This stage is also harder to characterize, serving more as a bridge between stage five and stage seven at the end of the scale. At this point, there will be a noticeable deeping of the hair loss at the hairline and vertex of the head. The narrow band of hair that separated the crown area from the back of the head will have disappeared, leaving hair along the sides and near the ears but removing it everywhere else. 

Stage Seven – As the final stage of the Norwood Scale, stage seven represents the most severe form of hair loss. The only remaining hair (if there is any) will be a strip along the sides of the head, forming the distinctive horseshoe. While sparse hair may be scattered across the scalp, it will be very thin.

Time To Act?

What Stages Need Hair Transplant Treatment?

Now that you’ve been informed about the stages of the Norwood Scale and how to identify them, it’s important to know when to start seeking advice about hair treatment and a possible transplant. As the Norwood Scale progresses, your chances of success and options for treatment begin to decline. 

Within the first two stages of the Norwood Scale, hair loss is not significant enough to warrant a transplant. However, this is when you will begin to notice hair loss and so it will be beneficial to have a consultation with a professional who can give you a rough estimate of when to seek treatment.

In terms of success, stages three, four, and sometimes five will be your best bet. At these stages, the hairline has begun to recede but the hair at the back of the head and scalp remains thick and healthy. The most common hair transplant techniques rely on taking follicles from a healthy donor area, so acting now before hair loss progresses will give you the best possibility for a successful transplant. 

This does not mean that there is no hope for someone seeking a hair transplant in stages six and seven of the Norwood Scale. As long as hair remains somewhat dense and thick at the back of the head or the neck (common donor areas) there can be a successful transplant. With the latest technique, doctors can even remove hair follicles from other areas of the body, giving hope to people with total hair loss. Just keep in mind that a transplant at this stage will be more expensive, time-consuming, and painful due to the amount of the head that needs to be covered. 

The Solution?

What Treatments Work Best

There are two core treatments for hair loss, and they share some key similarities. The first is the Follicular Unit Transplant, also known as the FUT technique. During this procedure, a surgeon will cut a small strip of skin from the donation area, usually on the back of your head. The individual hair follicles will then be removed from the strip and inserted into the receiver area, where hair is thinning or balding. This treatment relies on a healthy area of skin with dense hair growth, so it would work best in the earlier stages of the Norwood Scale.

The second common procedure is the Follicular Unit Extraction technique, also known as FUE. It is the more recently established of the two, and has become the standard for hair transplant. This is because this technique allows the surgeon to use a micropunch tool to remove individual hair follicles and insert them into the scalp, as opposed to removing an entire section of follicles as seen in the FUT technique. With this procedure, you could potentially donate hair follicles from other parts of your body rather than the back of the head. All you need is a hair follicle with healthy growth. This means that the FUE technique could work best for people in the later stages of the Norwood Scale who are losing overall hair density.

While each case is different, most surgeons will recommend the FUE technique for patients during each stage of the Norwood Scale. This is because the method of extracting individual hair follicles for transplant into the balding area will typically have a smoother and less noticeable appearance than the FUT technique. This is not to say that the FUT technique is obvious! Results are usually very subtle and natural. However, a small scar can remain at the back of the head where the small strip of skin was extracted. Talk to your doctor about what method will work best for you, depending on where you’re at in the Norwood Scale and other factors such as payment and time. 

 

What Next?

Now that you know a little bit more about the Norwood Scale and the best methods of treatment, it’s time to think about the logistics. Payment is the most obvious logistical concern, as most insurance agencies will not cover cosmetic procedures such as hair transplants. It may be beneficial to start saving up as soon as you notice thinning or balding in order to have a nice safety net when the time comes to book a procedure. The next question is one you may not even think to ask – where should you get the procedure?

Turkey is quickly becoming known as the “hair transplant capital” of the world! This is because Turkey offers the same high-quality hair transplant procedures with amazing results as other countries, but at a much reduced cost and wait time. In fact, it would be cheaper to fly to Turkey, get a hair transplant, do some sightseeing, and fly home than to get a single hair transplant procedure in the United Kingdom. Turkey has a high reputation as a medical procedure destination, in which you can take a small vacation as well as getting a procedure that will restore your confidence. A single trip to Turkey could be all you need to jumpstart your hair growth without breaking the bank. As you classify where exactly you fall on the Norwood Scale, consider a consultation and visit to Turkey to resolve your issue and come home feeling like a new man.

Essentially, the Norwood Scale is only the first step in treating hair loss. It is important to recognize where you fall and stay ahead of the march of time so that you are not caught unawares. Don’t be afraid to talk to a professional and begin preparations for what to do when the day comes that you decide to get a hair transplant procedure. It could change your life!

Ready to take action?

Get Your Free Hair Transplant Consultation Today.

    Abadir from London talks about his hair transplant.

    About Revival Health Group

    Revival Group was founded with the belief that every person should have the right to high-quality medical treatments and procedures at an affordable price.

    In the United Kingdom and Europe – most people find it difficult to afford professional healthcare and cosmetic treatments. You can book a treatment with us with full confidence and reassurance.

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