What is the Norwood Scale?

The Norwood-Hamilton scale — commonly called just the "Norwood scale" — is a classification system first described by Dr. James Hamilton in 1951 and later revised by Dr. O'Tar Norwood in 1975. It remains the global standard that surgeons use to:

Classify the pattern and extent of male pattern baldness
Predict future hair loss progression
Determine hair transplant candidacy and graft requirements
Plan the hairline design and donor area harvest

The scale has 7 primary stages (I–VII) with several sub-stages.

The Stages Explained

Stage I — No Significant Loss

The hairline is in its adolescent or early adult position with no recession. Most men have some natural temple recession that is not classified as loss.

Hair transplant: Not indicated.

Stage II — Slight Temple Recession

Minor recession at the temples. Many men at Stage II have more recession in their 30s than their teenage hairline but still have very dense coverage.

Hair transplant: Occasionally requested for hairline refinement. Only recommended if recession has been stable for 2+ years.

Stage III — Deep Temporal Recession

Deep temporal recession creating a more prominent "M" shape. This is typically when men first notice significant cosmetic impact.

Hair transplant: Good candidate. 1,200–1,800 grafts typical.

Stage IV — Significant Frontal and Crown Loss

Clear separation between the frontal zone (receded hairline) and the crown thinning. A band of hair still connects them.

Hair transplant: Strong candidate. 2,000–2,800 grafts typical.

Stage V — Bridge of Hair Narrowing

The bridge of hair separating the frontal zone and crown is narrow. Combined, the bald areas are large.

Hair transplant: Possible but requires careful donor assessment. 3,000–4,000 grafts.

Stage VI — Bridge Gone

The frontal and crown bald areas have merged into one large bald zone. Only a horseshoe of hair remains on the sides and back.

Hair transplant: Challenging. Focus is on frontal third for the greatest cosmetic impact.

Stage VII — Most Extensive Loss

The horseshoe of hair is narrow and sits low. Donor area is reduced in both density and safe harvest zone.

Hair transplant: Highly selective candidates only. Requires honest discussion about realistic coverage.

What Makes a Good Candidate?

The ideal hair transplant candidate:

Has stable hair loss (not progressing rapidly)
Has sufficient donor density — the back and sides of the scalp must have dense, healthy follicles
Is at Norwood Stage III to V (the sweet spot for best cosmetic impact vs. resource required)
Has realistic expectations — a transplant restores lost density but cannot create more hair than you have in the donor area
Is in good general health with no bleeding disorders or uncontrolled diabetes

How to Find Your Stage

At your free consultation, our surgeon will assess your Norwood stage, donor density, and scalp laxity in person. We can also give a preliminary assessment via WhatsApp photos.

The assessment is completely free — and honest. We will tell you if a transplant is not in your best interest.

The Norwood Scale Explained: Are You a Hair Transplant Candidate?