Male-pattern baldness stages — what to expect, and when to act
Male-pattern loss follows a predictable script. Knowing which act you're in decides which treatment costs least and works best.
Dr. Theo Marwick
Hair Restoration Surgeon · Marylebone
In short
- Progression averages 1 Norwood stage per 5–7 years untreated.
- Finasteride slows progression in 85–90% of men.
- The 'act now' threshold is Norwood 2–3.
- The 'transplant window' opens at stable Norwood 4+.
Male-pattern baldness is the world's most common medical condition after tooth decay. It's also one of the most predictable — which makes it eminently manageable if you know when to intervene.
The typical London timeline
- Ages 18–25: onset of Norwood 2. Temple recession begins.
- Ages 25–35: Norwood 2 → 3. Crown may start.
- Ages 35–45: Norwood 3 → 4. Bridge narrows.
- Ages 45+: variable — some men plateau at 4, others progress to 6–7.
Decision points
Norwood 2: monitor. Norwood 3: start medical therapy. Norwood 4 (stable 2+ years): consider surgery. Norwood 5+: combined plan mandatory.
The men who act at Norwood 2 rarely need surgery. The men who wait until 5 always do.
Frequently asked
Common questions
Can genetics predict my endpoint?+
Roughly. Look at maternal grandfather, but father matters too. Not deterministic.
Does stress accelerate MPB?+
Chronic stress can temporarily thin already-vulnerable follicles. It doesn't create MPB but can unmask it earlier.
Is there a natural stop point?+
Sometimes. About 20% of men plateau at Norwood 3–4 without intervention.
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