Your hair doctor is likely using the Norwood Scale to assess your hair loss progression. Learn how to use this scale yourself.
The Norwood scale is one of the most commonly used tools to help doctors, trichologists, dermatologists, and patients help better understand the extent of their hair loss.
This scale is made to be used in men who are dealing with male pattern hair loss, and it is likely not going to be useful for gauging female hair loss, as women tend to lose hair in a more diffuse pattern and use different scales. Women’s hair loss is commonly assessed using the Ludwig scale instead.
This scale is not the first hair loss reference tool to come into existence, far from it. The first hair loss scales for men date back from the 1950s with scales such as the Beek scale or the Hamilton scale. In time, new scales have been developed, including the Norwood scale from 1975, which is an updated adaptation of the Hamilton scale. Since these two scales are so similar, the Norwood scale is sometimes referred to as the Norwood-Hamilton scale.
The Norwood scale consists of 7 types when trying to classify a head of hair, as well as 4 “type A” subtypes within them to allow for some variation of the types where the hairline recedes faster than usual.
Below, we will cover example images of the Norwood scale, descriptions of each stage
Below is an illustration of the 7 Norwood scale types, and the 4 type A subtypes within them. The higher the numbers go in the scale, the more progressed the male pattern hair loss is considered to be.
If it is difficult to pin down your type, a written description of the types may help you better define where you stand.:
Norwood Scale Type 1: There is little or no hairline recession. This type may sometimes be used as a baseline to represent a head of hair with no hair loss.
Norwood Scale Type 2: There is recession of the hair on the temples, at the sides of the head. The recession may be triangular-shaped and symmetrical.
Norwood Scale Type 2A: Along with the symmetrical loss of triangular patches of hair at the temples, the hairline is also backed up further by at least 2 centimeters.
Norwood Scale Type 3: According to Norwood, this is the first type level that can be considered “baldness” to some extent. At this type, the temporal hair loss is deeper than type 2, and may be covered by no hair or only sparsely covered by hair. In this type the hair loss is mainly from the vertex with limited recession of the frontal hairline.
Norwood Scale Type 3A: The hair looks as described in type 3, with the addition of the frontal hairline also receding past the point of type 2, but not farther than the ears.
Norwood Scale Type 4: The frontal region is distinctly separated from the crown (vertex region) by a band of dense hair. The vertex may be sparsely covered by hair or not covered by hair. The dense band of hair connects with the hair at the sides of the head.
Norwood Scale Type 4A: Similar to type 4, except the hairline has also receded back past where the ears attach to the head, but not far enough to reach the vertex.
Norwood Scale Type 5: The areas of frontal hair loss and hair loss at the crown (vertex region) are still separated, but less distinct. The band of hair separating the two thinning areas is sparser than in type 4, and the areas of hair loss are larger.
Norwood Scale Type 5A: Similar to type 5, except the hairline has also now receded back enough to combine with the hair loss area of the vertex, leading to no band across the head any longer. Hair loss past this point may be indistinguishable from Type 6 or 7.
Norwood Scale Type 6: The bridge of hair spanning across the head is now gone or has only sparse hair remaining. The frontal and vertex regions have joined, and the areas of hair loss may be larger.
Norwood Scale Type 7: This is the most severe hair loss type. Usually, only a narrow horseshoe band of hair remains along the sides and back of the head. This hair may also now be thin and sparse.
Doctors can use the Norwood scale to get a baseline on your hair, monitor any hair loss progression, monitor any treatment progress, or help communicate how your hair looks when maintaining your patient profile, or treating you via telemedicine.
This scale can also be a good way to determine if someone is a good candidate for specific treatments. For instance, topical and oral treatments like Minoxidil or Finasteride are much more suited to hair loss which is in the beginning stages and has been “caught early”.
Hair loss that has progressed too far, or left untreated for too long, may mean that some of the sparse areas now have dormant hair follicles which do not respond well to topical or oral treatments any longer. In general, the first few stages may be good candidates for oral or topical hair loss treatments, but the last few stages may need to look into surgical options if they wish to drastically improve their hair loss.
Your doctor can take your hair loss stage into consideration when recommending treatment options.
It is best for a medical professional to assess your Norwood type on this scale. But, if you are curious, want to know where you may fall before your doctor’s visit, or you are keeping track of changes and progress in your own hair, it is possible to roughly gauge your type yourself.
Grab a camera, stand in front of a mirror, employ a selfie stick, reach your arms out, or involve a friend or family member to help you take images of your hair which you can use as a reference. Having images of your hair can help you better assess the stage of your hair loss, and it also gives you a baseline to compare to a few times a year.
There are roughly 5 places you will want to capture in your pictures to get a well-rounded idea of what is happening on your scalp. Take your photos in a well-lit area and try to take your hair images in the same place at roughly the same lighting each time to better compare them later.
The hairline: Get a picture of your hairline and the top of your forehead. You may need to slightly tilt your head down to get this photo.
Both temples: Turn to the side or have a friend take two pictures of the sides of your head so that you can see how the hair looks covering the temples.
The crown of your head: This one can be tricky, but tilt your head forward and reach the camera overhead, or ask a friend to get a good image of the crown of your head. This is the area where a “bald spot” may start forming.
The back of your head: The back of your head is normally the place that will hold onto hair the longest, but it is important to get a quick image to see if there are any changes there over time.
Here at Strut Health, we offer an easy way to get Telemedicine treatments for male pattern hair loss. We have a range of topical and oral treatments containing Minoxidil, Finasteride, and Dutasteride.
Our medications are best suited for men who have just started noticing changes to their hair, or are in the first few stages of hair loss.
If you are interested in seeing if a hair loss medication can help your hair, you can have a free online consultation with our U.S. licensed doctors today. If you are a good candidate for treatment, your medication can be shipped to your front door with our free shipping.
If you have any questions or need adjustments during treatment, our staff and doctors are available for free unlimited follow-ups.
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