The Norwood scale explained — what stage am I, and what does it mean?
Every hair-loss consultation in London starts with your Norwood stage. Here's how to read the scale honestly — and what each stage means for your next step.
Dr. Amara Okafor
Consultant Trichologist · Harley Street
In short
- Norwood 1–2: no treatment needed; monitor.
- Norwood 3: medical therapy is the entry point.
- Norwood 4–5: consider transplant if stable, medical if not.
- Norwood 6–7: transplant possible but expectations must be realistic.
The Norwood scale, developed in the 1970s and refined since, classifies male-pattern hair loss into seven stages. Every London hair-loss consult uses it. Knowing your stage before you walk in makes the conversation faster and cheaper.
The stages, plainly
- Norwood 1 — no visible recession. Nothing to do.
- Norwood 2 — slight temple recession, adult hairline. Photograph annually.
- Norwood 3 — deeper temples, sometimes crown thinning. Medical therapy window opens.
- Norwood 4 — clear frontal loss with a 'bridge' of hair. Combined medical + potential surgery.
- Norwood 5 — bridge narrows; frontal and crown loss connect.
- Norwood 6 — bridge gone; horseshoe pattern emerges.
- Norwood 7 — advanced horseshoe; donor becomes limiting factor.
What each stage means for treatment in London
Stages 2–3 are the medical therapy sweet spot — finasteride, minoxidil, ketoconazole shampoo. Stage 4 is decision territory: transplant is possible but only if loss has plateaued. Stages 5–7 need a long-term donor plan; a good London surgeon may decline stage 7 cases where donor is thin.
The best time to start medical therapy is Norwood 2. The second best is today.
Frequently asked
Common questions
Is there a female version?+
Yes — the Ludwig scale (three stages). See our Ludwig scale guide.
Can I go from Norwood 3 back to Norwood 2?+
Rarely without surgery. Medical therapy stabilises and thickens; it doesn't reverse the hairline.
Which stage is 'too late' for a transplant?+
Norwood 7 is the practical ceiling. Donor limits — not desire — decide.
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