EXPERT GUIDE

Norwood Scale: Types and Treatments

Medically reviewed by Dr. Sternberg Written by David Stelzer on 2 Feb 2021

Male androgenetic alopecia (AGA), i.e. genetic hair loss, follows a typical pattern in most cases, which is illustrated by the Hamilton-Norwood scale. According to this scale, androgenetic hair loss is divided into seven stages. Prior to most hair transplants, the patient’s degree of hair loss is identified using the Hamilton-Norwood scale.

This scale is then used to determine the number of grafts needed for the transplant and to make a prediction about the cost of treatment. The scale can also be used to predict the further course of hair loss.

Norwood Type 1

The hair on the head is not or is hardly affected by hair loss. Small receding hairline corners may be present:

In order to treat a hair loss of NW type 1, it is necessary to insert at least 800 grafts. The grafts usually come from the region of scalp hair not threatened by hair loss. According to our current cost study, the price for 800 transplants in the US would be between 4,000-4,500 USD and in the UK it would cost between 2,250-2,750 USD. For NW type 1, hair transplantation in Turkey is not considered to be a cheaper option, since the costs for flights and accommodation must be added.

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Norwood Type 2

With type 2 a receding hairline is formed. If an imaginary line is drawn across the head (about 2 cm in front of the ears), the receding hairline ends before this line. The front part of the hairline can also have a minimal amount of thinning:

In order to cover a hair loss of NW type 2, it is necessary to insert at least 1,400 grafts. The grafts usually originate from the back of the head where the hair is not threatened by balding. According to our current cost study, the cost for 1,400 hair transplants in the US would be between 7,000-8,000 USD and in the UK, it would cost between 4,000-5,000 USD. In Turkey, the cost for NW type 2 would be between 1,200-1,600 USD.

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Norwood Type 3

In type 3, the hair loss falls behind the imaginary line drawn over the head two centimeters in front of the ears. The hairline may also recede:

In order to treat hair loss of Norwood type 3, at least 2,250 grafts must be inserted. The grafts usually originate from the back of the head where the hair is not threatened by balding. According to our current cost study, the costs for 2,250 transplants in the US would be between 11,500-13,000 USD and in the UK, it would cost between 6,500-8,000 USD.  In Turkey, the costs for NW type 3 would be between 2,200-2,600 USD.

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Norwood Type 3 Vertex

In addition to the receding hairline, patients with type 3 have a vertex, or crown, that also has thinning hair or advanced hair loss:

The number of grafts needed to cover this hair loss depends on the density you want to achieve. For a density of 30 grafts/cm², 2,500 to 3,500 grafts are required. The cost of 3,000 grafts in the US would be between 15,000-17,000 USD and in the UK it would cost between 8,500-10,500 USD according to our current cost study. In Turkey the costs for NW type 3 would be between 2,800-3,500 USD.

Our tip

In our hair restoration cost study we found there are not only considerable price differences between individual surgeons and clinics, but also that the hair transplant methods and quality vary greatly. This makes it even more important to obtain comprehensive information. Our hair loss experts will be happy to help you and find the best and most affordable method and clinic for your hair loss: Request a hair loss analysis now

Norwood Type 4

With type 4, the receding hairline and hair loss at the hairline have spread so far that now only a narrow band of hair separates the frontal hair loss from the advanced hair loss in the vertex region:

To perform a transplant for a patient with NW type 4, it is necessary to insert at least 3,000 grafts. The grafts usually originate from the back of the head where the hair is not threatened by balding.  The cost of 3,000 grafts in the US would be between 15,000-17,000 USD and in the UK, it would cost between 8,500-10,500 USD according to our current cost study. In Turkey, the costs for NW type 4 would be between 2,800-3,500 USD.

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Norwood Type 5

In NW type 5, the hair band consists of only a few hairs:

In order to treat a hair loss of NW type 5, it is necessary to insert at least 4,000 grafts. The transplants mostly originate from the back of the head where the hair is not threatened by balding. According to our current cost study, the cost of 4,000 transplants in the US would be between 20,000-23,000 USD and in the UK it would be between 11,000-14,000 USD. In Turkey, the costs for NW type 5 would be between 3,500 and 4,500 USD. Since many hair surgeons only transplant up to 3,000 grafts in one outpatient procedure, the hair transplantation would have to be spread over several sessions.

Norwood Type 6 and 7

In type 6 and 7 there are no more hairs in the frontal and parietal region, i.e. on the top of the head. The crown is now clearly visible and has very few to no hairs remaining:

   

In order to treat a hair loss of NW type 6 or 7, at least 5,000 grafts must be inserted. The transplants usually come from the back of the head where the hair is not threatened by balding. According to our current cost study, the costs for 5,000 transplants in the US would be between 25,000-30,000 USD and in the UK it would cost between 14,000-18,000 USD. In Turkey, the costs for NW type 6 or 7 would be between 4,500 and 6,000 USD. Since many hair surgeons only transplant up to 3,000 grafts in one outpatient procedure, the hair transplantation would have to be spread over several sessions.

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At what Norwood Scale type should you take action?

An individual should take action to combat hair loss as soon as they notice signs of a receding hairline or thinning hair. The earlier preventative measures are taken, the more effective they are in stopping hair loss. You will be able to retain more of your natural hair by starting medicinal treatment like finasteride or minoxidil early on. The more extensive the hair loss is, the more difficult it becomes to treat. According to the current medihair hair transplant study most of the patients who are seeking a hair transplant have a NW4 type:

Hair loss degree prior to hair transplant

 

Treatments for Hair Loss

Minoxidil and finasteride are medicinal treatments used to stop the progression of hair loss.

The drug finasteride inhibits the enzyme reductase of 5α- DHT. This means that the conversion of testosterone to dihydrotestosterone (DHT) is blocked. The hormone DHT reduces the growth phase of the hair follicles and the result is hair loss.

Minoxidil is applied as a topical solution known as Regaine or Rogaine, to the affected areas of the scalp. It works similarly to finasteride. According to the manufacturer, minoxidil can stop hair loss in 70-80% of cases, and in 30% of cases new hair growth is even stimulated and the hair shaft diameters increase. If the drug is used consistently, the first signs of visible progress can be seen after only three to four months, while maximum efficiency is seen after twelve months. After these twelve months the hair is visibly denser in 30-42% of patients.

 

Most common prescribed hair loss treatments

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Where is a hair transplant possible?

Hair transplantation offers are a dime a dozen. Furthermore, the regional price differences are high. Therefore, get an overview of the offers now and compare the hair surgeons in United Kingdom, US or Turkey based on experiences of real patients, costs and treatment methods:

Is your preferred country or city not included? No problem, you can easily request an overview of all suitable offers. Would you like to learn more about hair transplantation? Then inform yourself now in our guide!

Frequently Asked Questions

What is the cause of hair loss in women?

What is the best treatment for hair loss?

Can a hair transplant be done for NW5+?

Sources

What does your hair loss look like?

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