Understanding the 7 Stages of Baldness: A Roadmap to Hair Loss in Males
When confronting hair loss, it’s crucial to understand its progression. And to help with just that, dermatologists frequently utilise the Norwood-Hamilton Scale to assess the stages of male pattern baldness effectively.
This diagnostic tool not only helps pinpoint the current extent of one’s hair loss but also facilitates the exploration of appropriate treatment options. In a similar way, whether you’re just beginning to notice changes in your hairline or have been monitoring your hair loss for some time, familiarising yourself with the Norwood Scale can clarify the progression of baldness, allowing for a well-informed approach to managing and treating the condition. This understanding is invaluable in setting realistic expectations and strategising future hair restoration efforts.
Decoding the Norwood Scale
As mentioned earlier, understanding the progression of male pattern baldness is crucial, and the Norwood Scale is instrumental in this regard. Also known as the Hamilton-Norwood Scale, this classification system breaks down male hair loss into seven detailed stages. Each stage reflects a progression from minimal hairline recession to significant baldness, offering a visual and descriptive way to gauge hair loss.
The scale provides a structured approach to identifying the extent of baldness, which is pivotal when considering treatment options. This means that regardless of whether you’re just starting to notice thinning or are further along, the Norwood Scale helps clarify the level of hair loss, allowing for informed decisions about interventions that might include medications, topical treatments, or even hair transplant procedures. Simply put, understanding where you stand within this framework can guide effective treatment choices and help manage expectations realistically.
The 7 Stages of the Norwood Scale: A Detailed Breakdown
So, if you’ve been wondering how long male pattern hair loss takes and what the progression looks like, the Norwood Scale provides a structured insight.
Stage 1
In Stage 1, the hairline remains fully intact with no visible signs of recession or indications of any impending baldness. Individuals in this stage maintain a complete head of hair, closely resembling the youthful hairline they have had since adolescence. This stage serves as the baseline for comparing subsequent stages of hair loss.
Stage 2
Stage 2 marks the beginning of the hair loss journey, where slight recession starts to show, especially around the temples, often creating a subtle “M” shape. This initial change is usually mild and may only be noticeable to the individual experiencing it. And more often than not, this early sign can be a prompt for preventative treatments.
Stage 3
As hair loss advances to Stage 3, the recession at the temples deepens more noticeably, enhancing the “M” shape. In addition, some individuals might begin to see thinning at the crown, often manifesting as a small bald spot, signalling a progression in hair loss. Due to its visible nature, this stage often triggers more proactive treatment approaches.
Stage 4
Moving into Stage 4, the temple recession becomes more pronounced, and the crown thinning is now unmistakable. The separation between the frontal hair loss and the crown starts to define itself more clearly, marking a significant turning point in the balding process.
Stage 5
At Stage 5 of the Norwood Scale, the progression of hair loss becomes more aggressive, showing a distinct expansion of the bald areas at the crown and the front. The hairline recedes further back from the forehead, enhancing the ‘M’ shape to a more pronounced ‘U’ shape in many cases. A key characteristic of this stage is the thin band of hair that still separates the bald zone at the crown from the receding hairline at the front. However, this band becomes markedly thinner and less dense than in previous stages, indicating a significant loss of hair.
Stage 6
Stage 6 is characterised by the merging of the frontal and crown bald areas, leaving a very thin or completely absent strip of hair that once separated them. At this stage, the extent of hair loss is more severe, with fewer options for reversal, focusing more on hair restoration techniques.
Stage 7
Stage 7 marks the most advanced phase of male pattern baldness, where the transformation is nearly complete. In this stage, the hair loss extends dramatically, leaving only a narrow, horseshoe-shaped band of hair that stretches around the sides and back of the head.
The top and the front of the scalp display extensive baldness, which is characteristic of this final stage. And at this point, the sparse hair that remains is often also quite thin and weak, struggling to survive on the fringes of the scalp.
The Progression of Hair Loss: How Long Does It Take to Move Through the Stages?
But, of course, understanding the timeline for hair loss through the stages of the Norwood Scale can be quite complex, as it varies from one individual to another.
For instance, factors such as genetics, hormonal changes, age, and overall health play crucial roles in determining the speed at which hair loss progresses. For some, the journey through the seven stages might span several years or even decades, showcasing a slow and gradual thinning and recession of hair. In contrast, others might find themselves advancing to more pronounced stages within just a few months.
It is also essential to recognise that progression through the Norwood Scale is not necessarily a linear process. Not every individual will experience every stage of the scale. Some might find their hair loss stabilising at an early stage without further significant recession or thinning, while others may rapidly progress to more advanced stages of baldness.
Given the diverse nature of this condition, personalised assessments and treatment plans are crucial for addressing individual needs and progression patterns.
Taking Action: Exploring Treatments for Hair Loss

Now, when it comes to addressing male pattern hair loss, the stage of progression on the Norwood Scale plays a crucial role in determining the most effective treatment approach. Whether early in the hair loss journey or at more advanced stages, there are tailored options available to help manage this common condition.
Minoxidil
Minoxidil is a topical treatment suitable to address various stages of male pattern baldness. It works by prolonging the growth phase of hair follicles, which may promote hair growth. Suitable for use in various stages of hair loss, from early to advanced, its effectiveness can vary, with visible results typically taking a few months to manifest. Side effects may include scalp irritation and increased hair shedding initially, which usually subsides with continued use.
Laser Therapy
Low-level laser therapy (LLLT) is another method aimed at stimulating hair growth through the use of light energy. Devices for home use, such as laser combs, are designed to enhance cellular respiration and promote hair density. However, while some users report positive outcomes, the clinical evidence supporting LLLT in treating male pattern baldness remains inconclusive.
Finasteride
Finasteride targets male pattern baldness at its hormonal source by inhibiting the enzyme that converts testosterone into dihydrotestosterone (DHT). Licensed in Singapore since 1998, this medication can slow or even reverse hair thinning in some users by reducing DHT levels in the scalp. Noticeable results might take a few months to manifest, but potential side effects include sexual dysfunction and mood changes. And while generally well tolerated, there are international cases that even suggest a potential risk of male breast cancer associated with its use, although the Health Sciences Authority (HSA) has not received any local reports.
Dermatological Procedures
Dermatological treatments like Platelet-Rich Plasma (PRP) therapy and mesotherapy are gaining traction for their potential to stimulate hair growth. PRP, for instance, involves injecting a concentration of a patient’s own platelet-rich plasma into the scalp to encourage healing and hair growth. Mesotherapy consists of injecting substances directly into the scalp to purportedly target hair loss at its source. However, the effectiveness and safety of these procedures can vary, and they may require multiple sessions to see results.
Hair Transplant Surgery
Hair transplant surgery offers a durable solution to hair loss, potentially delivering long-term results when performed at established hair transplant clinics. The primary techniques used are Follicular Unit Extraction (FUE) and Follicular Unit Transplantation (FUT).
- Follicular Unit Extraction (FUE): This less invasive method entails extracting individual hair follicles from the donor area—usually the back or sides of the head—using a punch tool. These follicles are then implanted into the balding areas, fostering a natural hairline and density without leaving significant scarring.
- Follicular Unit Transplantation (FUT): FUT involves removing a section of the scalp from the donor area, which is then divided into individual follicular units. These units are transplanted to the balding sections, similar to the FUE technique, but this method may leave a linear scar.
At What Stage of the Norwood Scale Can You Get a Hair Transplant?
Considering hair transplant to restore your hairline or address thinning areas?
Hair transplantation can be effective for individuals beyond stage three of the Norwood Scale, where balding patterns become more stable. This stability allows surgeons to better assess and plan the transplant, potentially minimising the need for future procedures. However, the suitability of a hair transplant and the technique used can depend on several factors, including the amount of available donor hair and the extent of balding.
Therefore, if you have advanced to the later stages of the Norwood Scale, visiting a hair loss clinic can help determine if you are an ideal candidate for a hair transplant. A consultation with a specialist will allow for a thorough assessment and provide guidance on the most suitable approach tailored to your specific hair loss needs.