STAGEWISE MEDICAL TREATMENT OF MALE PATTERN BALDNESS

Hairloss Baldness, Patient Education, Skin & Hair

In Today’s post, we will help you locate your stage of baldness on the international Norwood’s scale and suggest medical hair loss treatments for every stage for reversing baldness stage-wise backwards!

Will will not go into the science and mechanism of male pattern baldness in this video. We have discussed all these in our previous episodes.

Let’s get started!

Baldness is staged commonly using the International Norwood’s scale, the hair loss stages are described with a number ranging from 1 to 7 depending on the severity of hair loss.

Let’s start with:

Norwood Stage 1: This type describes the least amount of hair loss with an adolescent type of hair line. You can consider this normal unless you have a family history of male pattern baldness. If you have a family history closely monitor your hairline to determine if your hair loss develops into stage 2. And No Treatment is necessary at for stage 1.

Norwood Stage 2: This stage means a small amount of hair loss with progression to the adult type of hair line. Here there is slight recession of hair line around the sides or temples.
Regarding Treatment for this stage. If you have family history, first consult a doctor to verify that your hair loss is caused by male pattern baldness. There is a good chance that, with treatment, you can regain most of your lost hair and prevent progression into stage 3. You can start with simple treatment like 2 percent topical minoxidil application at this stage or start rolling a 0.5mm derma roller once a week with or without minoxidil solution. You can check out my detailed post on derma roller for hair loss.

Norwood Stage 3: This stage describes a mild to moderate amount of hair loss. This is the earliest stage of hair loss considered cosmetically significant enough to be called “baldness” according to Norwood scale. At this stage, most men show a deep bilaterally symmetrical recession of hairline at the temples that is sides, which are either completely void of hair or only sparsely covered with hair. This resembles letter M, U, or V shape. The vertex figure here shows the additional thinning of the hair at the crown of the head.
This is the most important stage of norwood, because you must start treatment as early as possible to prevent progression into stage 3. Remember, The higher the stage, the more difficult the treatment is.

Well, the treatment options at this stage, you may require a combination therapy like minoxidil 5 percent twice daily plus finasteride 1 mg tablet. This stage is stubborn for most people. If you are able to control or grow back hair at this stage, the baldness progression is generally slowed down in later part of your life.
Also the other treatment options you can consider at this stage are PRP and mesotherapy along with minoxidil. You can watch my detailed post on this PRP mesotherapy.

You can also consider Hair transplantation treatment at any stage from stage 3 onwards.

Norwood Stage 4: This stage describes a moderate amount of hair loss. At this stage there is further deepening and recession at the front of the head as well as the temple areas. Hair loss at the crown is also prominent now and a thick bridge of hair will separate hair loss at the front of the scalp from that at the vertex or the crown of the head. To differentiate this from stage 3, you can draw an imaginary vertical line tangential to the front margin of the ear. If hair loss crosses behind this line, then is stage 4.
Regarding the treatment options at this stage, there is no guarantee that using all the treatments including finasteride, minoxidil or a combination therapy will bring back all your lost hair. But the good news is if you start early treatment, the miniaturized hair will come back to normal and you can switch back to stage 3. You might have to use minoxidil in a higher concentration like 10 percent plus finasteride 1mg daily indefinitely. Please check my article on DHT to understand this miniaturization and the mechanism of hair loss.

You can also treat this stage with PRP and mesotherapy plus Stem cell therapy and consider hair transplant option at this stage too.

Norwood Stage 5: this stage marks the beginning of severe degree hair loss. In this stage, there remains only a thin separation between the loss of hair at the hairline and the loss of hair at the crown, the band of hair between the two is much thinner and narrower. Hair loss at both the crown and the temporal regions are larger and more distinct. The treatment options at this stage are same as that in stage 4.

Norwood Stage 6: In this stage there is a large amount of hair loss. The bridge of hair that once separated the front of the head from the crown is now almost fully lost, only a few sparse strands may remain. The remaining hair now forms a horseshoe shape around the baldness concentrated in the center of the scalp. Hair loss on the sides of the head will also extend further at this stage.
At this level, a hair transplant may be the only option.

Norwood Stage 7: The most advanced stage of hair loss, Here, only a wreath of thin hair remains on the sides and back of the scalp. This stage has the least chance of regaining your hair with any treatment.