Updated: Dec 11, 2020
There are many different reasons that a person might be experiencing hair loss. From nutritional deficiencies, to stress, to poor hair care and more, hair loss, whatever it may be caused by, is very common throughout the world.
Hereditary hair loss, also called androgenic alopecia, is by far the most common type of hair loss. If you have the balding gene, just like approximately 50 million men and 30 million in the U.S. do, there is a good chance that you will start to lose your hair at some point.
Just as common as hereditary hair loss is, so is the pattern that it typically follows. Androgenic alopecia causes men to lose their hair in an all-too recognizable pattern where it affects the temples, causing a receding hairline, and the crown, causing a bald spot in the back of the head. Luckily, in 1950, a man named James Hamilton created the Norwood scale.
As you can see above, it is essentially a seven-point scale that helps to determine the level of hair loss. It is based on the typical pattern and assesses the level of recession of your temples and the size of your crown’s hair loss. It can also be used to determine what types of treatments are likely to be most effective for you; depending on where you fall upon the scale.
In this article, we are going to look at which treatments will be most effective for you depending on how far your hair loss has progressed (i.e. where you fall on the Norwood scale).
Congrats, if you are a Norwood 1 you are probably showing very little or no signs of male pattern hair loss and probably still have a full head of hair.
Norwood 1 is essentially the “control”, or baseline level of the scale.
At this stage you do not need to worry about using treatments at all. Enjoy the hair while you have it, and only consider using treatments as you progress further down the Norwood scale.
This is the stage where you likely have noticed the first signs of hair loss. Whether it be hair in the shower, on your pillow, or maybe your hair just isn’t styling right, you probably have an inkling that you may be starting to lose it.
Although your hair loss is not bad yet, it is better to accept it now rather than deny it and let it get worse.
The first thing you should always do is talk to your doctor. Even though hair loss can be a sensitive subject, it is alwaysbest to get a professional to look at it. They will be able to not only prescribe you the necessary treatments, but will also be able to determine if it is being caused by something other than androgenic alopecia.
At this stage you should not focus on regrowth, as you have not lost much yet. Instead you need to focus on stopping the progression of hair loss by blocking DHT. There are several treatments that you can use to block DHT, although more likely than not your doctor will recommend finasteride: an FDA approved 5-alpha reductase inhibitor. Learn all about finasteride here.
This is commonly the stage after you first start to notice hair loss but before it gets bad. Although hair loss is definitely noticeable.
At this stage, you should already be using a DHT blocker. But, unfortunately sometimes people do not respond to treatments as well as they wish they had. If your hair loss continued to worsen after taking a DHT blocker (for at least 6 months), you likely are not responding well to it and need to do more to combat your hair loss.
Make sure you keep taking your DHT blocker though, you always need to keep DHT at bay to successfully overcome hair loss.
By the time you are a Norwood 3, your temples will likely have receded a decent amount and your crown may be starting to thin as well.
The best things to do at this stage are: one: continue to use a treatment that blocks DHT and two: it’s time to start using a treatment that is targeted towards regrowth; it will hopefully bring back some of your temple hair and stabilize the thinning in your crown.
At this point the hair loss has progressed quite a bit. This stage is where your temples have receded significantly and your crown is beginning to thin badly.
If you have been blocking DHT and using a regrowth treatment like minoxidil, but hair loss has continued to worsen, you probably got a bad luck of the draw and aren’t responding well to either type of treatment. This means that it is time to add less mainstream treatments to your hair loss routine.
Even though you may add new treatments, make sure you still are using a DHT blocker and minoxidil (or an alternative), because although it may not seem like they are working, they have been scientifically proven to be effective and will likely still have some effect, even if its minor.
There are many different treatments that you can add to your routine such as scalp massages, low-level laser therapy, the inversion method and more. Just make sure you do your research so that you are adding safe/effective treatments.
If you have now used a DHT blocker, minoxidil or a similar treatment, and several other treatments and still have not had success, not only is that unfortunate, but your non-surgical options are beginning to dwindle.
If you have reached Norwood 5, you are going to have severely receded temples and your crown will be very thinned out as well. Unfortunately, this means that many of your hair follicles are going to be dead, meaning that there is a very high chance that the treatments we mentioned above will no longer work. Although it is important to note that for any and every hair loss treatment, you need to wait at least 6 months before you decide that they are not working for you.
The harsh reality is that you are not responding to treatments and there are only a couple of things that you can do at this stage. You can try to keep using the treatments mentioned above in hopes that you eventually respond (while also considering using concealers such as hair fibers), you can embrace the hair loss and shave it off, or finally, if you are so inclined, it may be time to start googling “hair transplant doctors near me.”
This is the end of the line. If you have reached Norwood 6-7, with or without trying the treatments we mentioned, most of the hair on the top of your head is probably gone or severely thinned at this point. Unfortunately, any non-surgical treatment options are pretty much off the table at this point.
There are basically three options at this point: you can opt for a hair transplant, you could use a hair piece, or you could shave your head and consider undergoing a scalp micropigmentation procedure (essentially your head is tattooed to give the appearance of a youthful hair line, and they usually turn out looking good!).
As you can see, for whatever stage of the Norwood scale you find yourself at, there is a lot that you can do. Make sure you pay attention to your hair loss as it is always best to start treatments earlier rather than later. It will allow you to save more hair, whilst also requiring the use of less treatments (and saving money).