Why and How Is Hair Loss Type Classified on Norwood Hamilton Scale?

Date: 2 May 2016

The doctors, medical team and trichologists working on hair loss treatment classify and mention male pattern baldness with a code.  This code is coming from Hamilton-Norwood Scale. In 1950s Dr James Hamilton introduced the scale and later it is revised and updated by Dr O’Tar Norwood in the 1970’s. Dr O’tar Norwood modified the stages and added 3a, 3 vertex, 4a and 5a.

The Hamilton-Norwood Hair Loss Scale is a tool to assess how severe a man’s hair loss or his level of baldness.

Men lose their hair in different patterns. Some may lose the hair from temples, some may suffer from hair loss at the back of the head called vertex, some may have receding hairline and at the same time hair loss at the back.

If a man hair loss type is higher on the scale, that means his options are limited for hair loss treatment. For example, Minoxidil (Rogaine) and Finasteride are not useful anymore for the hair loss type 5 and over.

Let’s have an idea about Norwood Hamilton Scale that the medical team always mention. You can easily fit your hair loss type on scale by seeing the pictures and explanations below.

Norwood Hamilton Scale – Stage 1

Stage 1 is the least amount of hair loss in hairline and hence there is no need for the treatment. However if you have already genetic hair loss in your family, please follow your case and decide the appropriate time for the treatment with an expert.

Norwood Hamilton MCAN Health

Norwood Hamilton Scale – Stage 2

There are hair loss at the front temporal sides, the shape is like triangular at both part. Small amount of hair loss also appears in the middle of the front head. At this stage it is better to depict what the reasons are for hair loss, whether it is male pattern baldness or another reason.


Norwood Hamilton Scale – Stage 3

After stage 3, we can start to talk about baldness although it is the small to moderate amount of hair loss. Baldness in the temples are now clear with symmetrical recession and may be disturbing. Small amount of hair loss in crown area may also occur in this stage.


Norwood Hamilton Scale – Stage 4

Moderate level of hair loss in front temporal sides and receding hair and small open area occurs in crown part, vertex area. Starting from hairline to the crown, in the middle of the scalp, there are natural hairs with moderate density.


Norwood Hamilton Scale – Stage 5

A moderate to large amount of hair loss is available in Stage 5, hair loss at the back (vertex area) and hair loss in the front temporal parts are still separated with natural hairs. However the balding at temporal and vertex region are larger than before.


Norwood Hamilton Scale – Stage 6

Now we can talk about large area of balding and considerable amount of hair loss. Starting from hairline through the crown area, we can talk about balding area with only very thin natural hair. Hair loss on the sides are increased more.


Norwood Hamilton Scale – Stage 7

This is the last point of baldness. The hair is almost only available at the back of the head from one side to the another. Since the open area is very large, hair transplantation will only cover a certain part but not the all. This kind of baldness may require more than one session hair transplantation.


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