The Norwood scale is the standard way of describing male pattern hair loss. It runs from stage one, an unchanged adolescent hairline, through to stage seven, where only a band of hair remains at the back and sides. Knowing your stage is useful shorthand, though it describes a pattern rather than diagnosing why it is happening.
What do the stages look like?
Stage one is a full hairline with no visible recession. Stage two shows slight recession at the temples, which is common and often simply a mature hairline rather than the start of balding. Stage three is the point at which recession becomes clearly noticeable, with deeper temporal gaps; a variant, stage three vertex, adds thinning at the crown.
Stage four brings further frontal recession alongside a distinct area of crown loss, with a band of hair still separating the two. By stage five that band narrows, and at stage six it breaks down so the front and crown merge. Stage seven leaves hair only around the sides and back.
How many grafts does each stage need?
As a rough guide, early recession at stage two or three might need 1,500 to 2,500 grafts, stage four commonly 2,500 to 3,500, and stages five and six considerably more, often 4,000 to 5,000 or beyond a single session. These are ranges, not quotes. Your donor density, hair calibre and goals change the figure substantially, which is why an in-person assessment matters more than the number on a chart.
Does a higher stage mean I cannot have surgery?
Not necessarily, but it changes the plan. At advanced stages the demand for coverage outstrips what most donor areas can supply, so the sensible approach is to prioritise the frontal framing rather than chase full coverage, and to be realistic about density. Sometimes scalp micropigmentation alongside surgery gives a better overall impression than surgery alone.
What the scale does not tell you
It does not tell you why you are losing hair, how fast you will progress, or whether the loss is pattern-related at all. Diffuse thinning, telogen effluvium after illness or stress, thyroid problems and iron deficiency all produce shedding that the Norwood scale is not designed to capture. That is why assessment comes before any treatment decision.
Frequently asked questions
Can I work out my stage myself?
Roughly, using a mirror and photographs of the crown. It is a helpful starting point for a conversation, but it does not replace an examination of your donor area and scalp.
Does everyone progress through every stage?
No. Many people stabilise at a particular stage for years or permanently. Family history gives some indication, though it is not a reliable prediction.
What stage is best for a transplant?
There is no single answer. Stable loss with a good donor area matters far more than the number, and operating very early can mean chasing recession with repeat surgery.
Is there a female equivalent?
Yes, the Ludwig scale, which describes diffuse thinning around the parting rather than a receding hairline.
Book a free consultation at our Harley Street clinic for an assessment of your stage and options. This is general information, not a diagnosis.