The Norwood scale, stage by stage, in words

The Norwood scale is the shorthand surgeons use to describe how far male pattern hair loss has progressed. It runs from stage 1, an untouched hairline, to stage 7, where only a band of hair at the back and sides remains. It is a description, not a diagnosis and not a plan: two men at the same stage can need very different numbers of grafts, because the scale says nothing about the hair you have left to move. What it does do is let you and a surgeon start the conversation from the same word.

The stages below are written out rather than drawn. The published diagrams are copyrighted, and in any case your own three photographs settle your stage in a minute. If you want to know which stage you are, take the photographs.

Those ranges are planning bands used across the field, not a quote. The largest single session here is 4,500 grafts, and what your own donor area can safely give may be less than your stage suggests. How the number is actually calculated, zone by zone, is on how many grafts do I need.

What the scale tells a surgeon, and what it hides

Norwood describes the shape of what has gone. A surgical plan needs two more things it does not contain.

The first is the donor supply. A stage 5 with a thick, dense back and sides is an easier case than a stage 3 with a fine, sparse donor. The second is miniaturisation: hair that is still present in the thinning zone but shortening and thinning with each cycle. Those hairs are on their way out, and a plan that counts them as coverage will look wrong in three years. A surgeon examining you counts them; a photograph taken from two metres away does not show them.

This is why a stage on its own is never a price, and why any clinic quoting a graft number from your stage alone has skipped the part that matters.

Which stages are one session and which are two

Roughly, stages 2 to 4 are single-session cases, stages 5 to 7 are planned as two, and stage 4 sits on the line depending on the crown.

The reason is not stamina, it is arithmetic. Between 2,000 and 4,000 grafts is what a donor area can typically give in one sitting without thinning the back of the head, and a large bald area needs more than that to look dense rather than merely covered. Splitting the work also lets the surgeon see how your grafts actually grew before committing the rest of your donor supply, which is the sensible order for anyone who may need surgery again in twenty years.

The wait between sessions is twelve months, which is how long it takes for the first result to be final enough to judge.

Stage 3 vertex and stage 4: the crown question

The crown is where plans go wrong, because it is a whorl. Hair grows out of it in a spiral, so a thin patch there shows scalp from every angle, and filling it convincingly takes more grafts per square centimetre than the same area on the mid-scalp.

At stage 3 vertex and early stage 4 the decision is usually to treat the front first. The front frames your face, it is what you see in the mirror and what other people look at, and it holds its result for life if the design is age-appropriate. The crown can be revisited at twelve months, by which time you also know how your loss is progressing and whether spending donor hair there is the right call.

The Ludwig scale, for women

Norwood does not describe female pattern loss, because women rarely recede at the temples in the same way. The Ludwig scale is used instead, and it has three grades: grade 1 is mild widening of the parting with the frontal hairline preserved, grade 2 is clear thinning and widening across the top with the scalp visible through it, and grade 3 is diffuse loss of most of the hair on top with the hairline still standing.

Ludwig 1 and 2 with a stable, dense donor area can be surgical cases. Ludwig 3 usually is not, because loss that diffuse tends to include the sides and back and leaves nothing safe to harvest. The wider suitability questions for women and men both are on am I a candidate.

FAQ

Which Norwood stage am I?

Photograph the front of your hairline in daylight, the crown from above with your head tilted down, and the back of your head, all on dry hair. Then read the descriptions in the table: most people place themselves correctly within one stage. Where people get it wrong is the crown, because you cannot see your own, and mildly, in the other direction, the hairline, because a mature hairline at 30 is not stage 3.

At what stage should I have a transplant?

There is no stage that obliges you and no stage that is too late until the donor area runs out. What matters more than the number is whether the loss has slowed and whether your donor can fund the area you want covered. Many men do best treating a stage 3 or 4 rather than waiting for stage 6, simply because the area is smaller and the result denser for the same graft count.

Does a higher stage mean a worse result?

No, it means a different goal. Stage 3 can be restored to something close to a full look. Stage 6 is restored to coverage: a frame, a hairline, a mid-scalp that reads as hair rather than scalp, and a crown that may stay thin. Both can be good results. The disappointment comes from applying stage 3 expectations to a stage 6 head, which is why the planning conversation happens before any date is booked.

Can the scale predict how bald I will get?

Not on its own. Family history, the age at which your loss began and the amount of miniaturisation visible now are better predictors, and none of them is a certainty. This is why a hairline is designed for the face you will have at fifty rather than the one in the mirror today, and why medication to hold the hair you still have is discussed at the same time as surgery.

Clinically reviewed by the treating surgeon. Last reviewed 25 September 2026.