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Every clinic you contact will ask what Norwood stage you are, and most people have no idea. The diagrams below are the fastest way to find out — look at the one that matches your hairline in a mirror, and you have the answer.
Seven stages, drawn rather than describedThe graft range and technique for each oneThe number every clinic will ask you for
No visible recession
Slight temple recession
Clear M-shaped hairline
Temple recession plus a thinning crown
Deeper recession with a defined crown patch
The bridge between front and crown is narrowing
Front and crown have joined
Only a band of hair at the sides and back
The scale describes a progression, not a diagnosis. Where you are on it matters less than how fast you got there and what your donor area looks like.
The adolescent hairline is still intact. Both temples sit on the same line as the rest of the hairline and the crown is fully covered.
What is usually done
Nothing needs transplanting at this stage. If you have a family history of hair loss, a baseline photograph and a density measurement now make any future change easy to detect.
The hairline has moved back a little at both temples, forming the first shallow triangles. The forehead looks marginally taller in photographs taken from the front.
What is usually done
A small, precise session is enough. DHI places single-hair grafts at the very front, which is what keeps a rebuilt temple from looking like a straight line.
The temples have receded deep enough to be the first stage most clinicians call pattern hair loss. The hairline now reads as a clear M.
What is usually done
One session usually rebuilds the frontal third. Ask what hairline height is being planned: a line drawn too low at this age is the most common reason a result stops looking natural later.
The same frontal recession as stage 3, with hair at the vertex thinning independently. Two separate areas are now losing density.
What is usually done
Two areas compete for the same donor hair. Most plans prioritise the frontal line, because it frames the face, and treat the crown with a lighter density or in a second session.
The frontal loss is substantial and the crown has become a distinct bald area. A band of hair still bridges the two across the top of the head.
What is usually done
This is the stage where donor planning starts to matter more than technique. A good plan reserves grafts for the future rather than spending the whole donor area in one sitting.
The band separating the frontal area from the crown has thinned noticeably. Both regions are larger than at stage 4 and are beginning to read as one.
What is usually done
Full coverage at natural density is rarely realistic here. The honest version of this plan is a strong frontal result with the crown filled to a lighter, but even, density.
The bridge has gone and the bald areas are continuous. Hair remains on the sides and the back, which is where the donor supply comes from.
What is usually done
Plan for two sessions separated by about a year, so the donor area has time to recover. Prioritising the front and mid-scalp gives a far better everyday result than spreading grafts thinly over everything.
The most advanced pattern: a horseshoe of hair around the sides and the back of the head, with the entire top bare.
What is usually done
The donor area, not the bald area, sets the limit at this stage. A frame-the-face plan with a conservative hairline produces a result you can live with; promises of full coverage usually cannot be kept.
The Norwood scale was published in 1975 and is still the shorthand every hair clinic uses, because it predicts something useful: roughly how many grafts a case will need. It is not a medical diagnosis and it says nothing about why you are losing hair.
Take a photograph under a bright overhead light, with dry hair, from the front and from above. Hair arranged to cover a thin area will put you a stage lower than you are, which helps nobody. The photograph is the measure, not the mirror.
Two people at stage 4 can need completely different plans. The scale describes the area to be covered; it says nothing about the donor area that has to supply it, and the donor area is what decides what is possible. A stage 6 with a dense donor area has better options than a stage 4 with diffuse thinning at the back.
Pattern loss is progressive. A good surgeon plans for the stage you are heading towards and not the one you are at, which is why a 26-year-old at stage 3 is usually advised to hold grafts back. If nobody raises this with you, raise it with them.
