Male Pattern Baldness – Early Signs, Stages and Treatments

Hairloss Baldness, Patient Education, Signs and Symptoms, Skin & Hair, Treatments & Cures

In Today’s article on hair loss, we will look into some important early warning signs to pick up male pattern baldness and start early treatment to prevent further hair loss or even reverse hair loss as early as possible. We will also help you locate your stage of hair loss on the commonly used international Norwoods scale and discuss on what hair loss treatment to use for that particular stage.

Lets begin!

Picking some early signs can certainly help you combat male pattern baldness either to stop further progression of hair loss or even reversing hair loss. And remember – Prevention is always better than Cure! First of all, try to assess yourself whether you are prone to male pattern baldness or not by considering these important factors:

Age: Male pattern baldness or androgenetic alopecia can start at any age after puberty around the age of 15. Roughly, your risk to baldness is 20% in your twenties, 30% in your thirties, 40% in your forties ties and so on, that’s rising 10% for every decade of your life. Not only your age, but you have to watch out other factors too to deal with baldness prevention.
Genetics: If you have a strong family history, you have to be double or triple cautious to apply preventive steps. And Hair loss, as discussed in my previous episodes – its polygenetic – meaning multiple genes are involved, from maternal side or paternal side or a combination. You might have to even look at your uncles from both sides to assess your risk.
Other Factors like Stress, Smoking and Nutritional deficiencies are also important in adding that risk for baldness. So, if you want to save your hair, better be cautious of these habits and do not forget to read my previous important article on the bad habits that cause hair lossbad habits that cause hair loss.

Now! Lets look into the early warning signs of balding. We all know that balding can be a traumatic process for everyone. The one who is pretending to be cool with his baldness is a big liar. Well, the good news is by spotting the early warning signs of balding, you can start applying some preventative measures to secure your hair. Yes nothing is impossible!

So, how do I know whether I am going bald or will become bald? We use the International scale for staging of baldness in men – that’s called the Hamilton-Norwood Scale for androgenetic alopecia or the male pattern baldness. This scale is regularly used by doctors to assess the severity of baldness and depending on the stage of baldness, you have different treatment options and also it helps to assess whether this particular treatment option will be effective or not.

In this Norwood scale, the hair loss stages are described with a number ranging from 1 to 7 depending on the severity of hair loss.

Norwood Hair loss 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 this stage.

Norwood Hair loss 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.

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 minoxidil topical 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 derma roller article here.

Norwood Hair loss 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.

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 check out my detailed article and video on this PRP mesotherapy.

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

Norwood Hair loss 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 hairloss 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. Please read my article on DHT and hair lossDHT and hair loss to understand this miniaturization and the mechanism of hair loss.

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

Norwood Hair loss 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 Hair loss 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 Hair loss 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.

Switching back to an earlier stage with Treatment:

Yes this is possible with the treatments at every stage as discussed. Though these treatments will not restore a full head of hair, but these can certainly help one to climb back into a lesser stage of the Norwood scale. For example, with stage 6 hair loss, a reasonable outcome with treatment is a return back to stage 5 or even 4 if proper treatment is started.