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Hair Loss in Men: Understanding the Norwood Scale


Understanding hair loss and the Norwood ScaleMale pattern baldness is called such because the hair loss typically occurs in a patterned, somewhat predictable way. While men who are losing their hair tend to lose it at different speeds, the loss typically occurs on the top of the head and at the temples. A system called the Norwood scale has been in use since the 1970s to measure the degree of hair loss on a man.

The Norwood scale features seven types, or degrees, of hair loss. The first type, Type I, is minimal, barely noticeable hair loss. The seventh type, Type VII, is the most dramatic. Just as the Ludwig scale is only used for women, the Norwood scale is only used to diagnose hair loss in men.

The Norwood Scale is also called the Hamilton-Norwood Scale. Dr. James Hamilton created a scale to measure male baldness back in the 1950s. Dr. O’Tar Norwood updated the Hamilton scale two decades later. Neither version of the scale takes all of the possible patterns of baldness under consideration. Instead, the scale shows the most common types of male pattern baldness.

Understanding the Types

Knowing what type you are on the Norwood scale can help you and your doctor decide on the best course of treatment for your hair loss. For example, if you are Type I on the scale, you have very minimal hair loss or you haven’t started to lose your hair yet.

If your hair matches the image used for Type II on the Norwood Scale, you’ve started to lose some hair, mainly at the temples. At this state, your hair loss is still insignificant. Type III on the scale can take two forms. You may have noticeable hair loss at your temples or along the hairline. Type III vertex on the scale means you have begun to have noticeable hair loss on the top of your head. Usually, Type III hair loss is the first stage that can be treated.

Type IV hair loss typically involves a noticeable amount of hair loss on both the hairline and the top of the hair. Men who can be classified with Type V hair loss have started to lose a large amount of hair. The bald spot on the top of the head is large and the hairline has receded considerably, but there is still a patch of hair separating the hairline and the bald spot.

Types VI and VII are the most pronounced types of hair loss. Men with Type VI hair loss have just a few strands of hair left on the top of their head. Men with Type VII hair loss have almost no hair left on the top of their heads.

The Scale also includes Type A classifications. Men who fall under the Type A classification have no bridge of hair separating the bald spot on the top of the head and the receding hairline. Instead, they primarily lose hair by having their hairline continue to recede.

Diagnosing Hair Loss

The Norwood Scale is just one part of the process of diagnosing male pattern baldness. Usually, a doctor will ask the patient for a family history and a medical history. Taking a medical history can rule out whether or not the hair loss is related to a health issue or medication. The doctor will also examine the hair follicles to see if there is any miniaturization connected to male pattern baldness.

Getting the Right Treatment

Some men might decide to accept that they are going bald and not treat their hair loss. A good many others, though, will do anything to keep the hair on their heads. The appropriate treatment for hair loss depends on how far the hair loss has progressed and the cause of it. If the doctor has diagnosed a patient with male pattern baldness, where that baldness falls on the Norwood Scale plays a big role in determining the right course of treatment.

For example, if the patient’s hair loss resembles the image used for Type II on the Norwood Scale, it is most likely too early for hair restoration surgery. The patient can continue to lose his hair, meaning that additional surgeries will be needed as time goes on. Talking to a hair restoration specialist about your options is an important part of determining the best treatment for your hair loss, no matter where you fall on the Norwood Scale.

Hair restoration specialist Dr. Kyle Choe performs hair transplants in Virginia Beach. To learn more about your hair loss treatment options, contact Dr. Choe at the Choe Center for Hair Restoration today. Call (757) 389-5850 for a consultation.

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