The Hamilton-Norwood Scale - Male hair loss Causes

This scale is used by hair transplant surgeons and clinics as a means of categorising hair loss in men.

Hair loss is women is categorised using the Ludwig scale.

This is used to determine the level of hair loss in a patient and their suitability for a hair transplant.

There are seven stages with 1 being no or little hair loss through to 7 which is completely bald on the top of the head. These are categorised as ‘types’.

Seven stages of hair loss

The 7 stages are as follows:

  • Stage 1: none or little hair loss (type 1)
  • Stage 2: Hairline is starting to recede at the front of your head (near your temples). There may be a small patch of thinning hair on the top of your head (type 2).
  • Stage 3: hairline has receded further back on the head. The bald patch on your head will have become larger and more noticeable (type 3). There is also a type 3 vertex: this is where hair has receded to near the vertex.
  • Stage 4: hairline has receded to the top of your head. Your bald patch is even bigger (type 4). You still have a division line between the two.
  • Stage 5: no hair at the front of your head. Your hairline has receded to the point where it now starts from the vertex (crown) of your head (type 5).
  • Stage 6: this dividing line of hair has gone leaving you with just a few strands of hair (type 6).
  • Stage 7: the severest form of hair loss. Little or no hair at the front or on top of the head. Remaining hair around the back of the head, above the ears in a ‘horseshoe’ pattern (type 7).

This scale is used to determine which hair transplant method is suitable for you and your type of hair loss. It is also used to determine the number of hair grafts you will need. The higher your ‘type’ the more advanced your hair loss. So if you are a type 5 then your hair loss is more serious than someone who is a type 2.

Plus if you start to lose your hair early on in life then there is a good chance that you will lose a great deal of your hair. Everyone is different in regard to how they will lose their hair. Some men may start to lose their hair in their twenties and progress to a type 4 or 5 whereas others might not start to lose their hair until middle aged but suddenly become type 6 or even a type 7.

The issue is what type of hair loss is best suited to a hair transplant? If you are designated a type 3 or higher and have suffered from male pattern baldness for the last five years or more then a hair transplant is a very good option.

But if you are under a type 3 or a type 5 or above then a hair transplant may not be your best option. The reasons for this are: in the first case, surgery on a type 3 or less is likely to be too unpredictable whereas someone over type 5 or more will not have enough hair to use as a donor site for the transplant.

Your hair transplant surgeon will decide whether your type of hair loss is suitable for surgery but you also have to be realistic about what can be achieved. The more advanced your hair loss, for example a type 6 or 7 on the Norwood scale then the less successful the results.

Other factors include the quality of the donor hair and the strength of the hair shaft.

Male hair loss Guide Index:



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