Understanding the 7 Stages of Hair Loss:

From Symptoms to Treatment

Anyone going through hair loss will tell you, it didn’t happen overnight. Although hair loss is a natural part of aging, one of the most prevalent forms of hair loss in men is male pattern baldness, scientifically referred to as androgenetic alopecia. There is a distinct pattern and progression to this type of hair loss. The Norwood Scale is most used to understand and define this balding progression.

Hair loss is never easy, but understanding the symptoms, causes and stages of male pattern balding can go a long way in helping with diagnosis and more effective management of this condition.

Treating hair loss is a lot harder in the later stages. Being able to spot any new patterns and recognize the stage you may be entering are your best tools in slowing and treating this hair loss.

The Hamilton-Norwood scale, a widely accepted classification system, outlines seven stages of male pattern baldness, providing a standardized method for understanding its progression.

What is Male Pattern Baldness?

Affecting only males or those assigned male at birth, male pattern baldness is the thinning and loss of hair from your head that happens over time. Often characterized by a receding hairline, this is a genetic condition that occurs when the hair follicles shrink over time, leading to shorter and finer hair until, eventually, the hair doesn’t grow back.

If you have a family history of male pattern baldness, you are more likely to experience it for yourself.

How Common is Male Pattern Baldness?

Unfortunately, this kind of male hair loss is incredibly common especially within certain ethnicities. Male pattern baldness affects people of Caucasian descent the most, followed by those of Afro-Caribbean heritage.¹ People of First Nations, Alaska Native and Native American heritage are the least likely to develop male pattern hair loss.

What Age Does Balding Start?

Male pattern baldness affects 30% to 50% of men by the age of 50². Genetics play a significant role in its development and at what age balding will start. While this condition often begins in the early 30s, some people may start to notice the early stages of hair loss in their late teens.

Does Male Pattern Baldness Affect My Body?

Apart from your hair follicles on your scalp gradually shrinking, there is no other effect on your physical body and male pattern baldness doesn’t compromise your physical health in any way.  This kind of hair loss can, however, take a negative toll psychologically and emotionally. Losing your hair can cause significant distress for many, with a marked impact on their self-esteem.

Early Signs of Balding and Causes of Male Pattern Baldness

The most common symptoms of male pattern baldness

The most common symptoms of male pattern baldness are thinning hair and a receding hairline. The formation of a bald spot on the top of the head or the crown is another common sign. Some people experience thinning of the hair around their temples.

The most common causes of male pattern baldness

Hair loss causes may vary but in terms of male pattern baldness, the cause is usually a mix of genetics and hormones. This type of male hair thinning is associated with the hormone dihydrotestosterone (DHT), a type of androgen, which shortens the hair growth cycle, leading to finer and shorter hair until hair follicles cease producing new hair.

If other male members of your family have male pattern baldness or if there is a history of male pattern baldness in your family, commonly on your mother’s side but also on your father’s side, the chances of you developing the condition are higher.

There is also a connection between age and male pattern baldness. The balding age range can start from the late teens or early twenties, with 50% of people experiencing hair loss by age 50. As you get older, the chances of experiencing hair loss grows.

What is the Hamilton-Norwood Scale and How Can It Help?

The Norwood classification, often referred to as the Hamilton-Norwood Scale or the Norwood Scale, is a classification system used to describe and categorize the different stages of male pattern baldness.

The system is a great tool in supporting men when it comes to monitoring their hair loss and helping with hair loss prevention.³

Dr. James Hamilton originally developed the system in the 1950s, and in the 1970s this system was updated and modified by Dr. O'Tar Norwood. By being able to assess the progression of your hair loss, it is much easier to find the right hair loss treatment options for you.  

The scale outlines seven primary stages of male pattern baldness, from minimal to advanced hair loss.

Hair Loss Stage by Stage

Stage 1: Minor, almost unnoticeable hair loss

At this first stage, hair loss is almost insignificant, and an individual will typically still have a full head of hair. While there are no visible signs of hairline recession or thinning, if you have a predisposition for male pattern baldness, this is a great stage to start putting some hair loss prevention strategies in place. This could be things like quitting smoking, choosing a healthy diet, or taking multivitamins. Read more articles on prevention here.

Stage 2: The start of the M-shaped hairline

During Stage 2, the hairline begins to mature slightly, with a minor temporal recession. This stage is often characterized by the development of a slight V-shaped or M-shaped hairline, which could be the first sign of hair loss for many. This is a good time to start with some hair loss remedies. The Phoenix telehealth platform can connect you with Canadian doctors and pharmacies that specialize in hair loss treatments such as Finasteride.

Stage 3: Balding patterns become more prominent

This stage marks a more noticeable progression of hair loss and recession becomes more evident, forming a deeper M, U or V-shaped pattern. At this point, hair thinning on the crown may also begin, although the area is not completely bald. According to the Norwood Scale, this is classified as the first stage of baldness.

Stage 4: More visible loss in the crown

The hairline recession has started to become more severe by this stage and the bridge of hair between the temporal regions and the crown of the head becomes thinner. As you lose more hair in the crown area, the distinction between the front and top areas of the head becomes more pronounced.

Stage 5: A horseshoe pattern forms

The progression of hair loss in Stage 5 is more severe than the previous stages. The bald areas on the crown and front of the head become larger, with only a narrow band of hair separating them. The two areas of hair loss might still be divided, but they are closer together, with the remaining hair leaving a horseshoe-shaped pattern on your head.

Stage 6: Bald Areas on crown and front of head merge

In this stage, the band of hair that separates the frontal and crown regions becomes thinner, and the bald areas on the crown and front of the head merge. The remaining hair is usually found on the sides of the head, above the ears, and the back.

Stage 7: Hairline and scalp almost completely bald

This is the most advanced stage of male pattern baldness. At this point, only a horseshoe-shaped ring of hair remains around the sides and back of the head. The crown is typically entirely bald, leaving minimal to no hair on the top of the head. While hair regrowth or hair restoration are unlikely at this stage, options such as a hair transplant remain.

How is Male Pattern Baldness Diagnosed?

Male pattern baldness or hair loss diagnosis primarily involves a physical examination by a healthcare provider, or you can start with an online assessment with a digital health clinic like Phoenix.

The pattern of hair loss and a family history of baldness will often guide the diagnosis. In some cases, a scalp biopsy may be recommended to rule out other potential causes of hair loss.

How Can I Manage or Treat Male Pattern Baldness?

There are several treatment options available to you to help manage male pattern baldness. Treatment includes medications like minoxidil and finasteride, hair transplants, and low-level laser therapy. Results may vary person to person, and it's essential to discuss these options with a healthcare provider.

It is important to keep in mind that results from treatments may take several months to become noticeable, and consistency in treatment is key to maintaining any progress. With free follow-ups on the Phoenix platform, you can connect with a physician to help monitor the progress of your treatment.

Can I Prevent Male Pattern Baldness?

While male pattern baldness is primarily genetic, some lifestyle factors may help in reducing its impact. Think about ways to make your diet healthier, and how you can reduce stress in your life. You may also want to avoid harsh hair treatments to slow down the progression of hair loss.

Living With Male Pattern Baldness

The progression of male pattern baldness is highly individualized. Some people may experience significant hair loss, while others might maintain a substantial amount of hair.

Early intervention and treatment often have the most positive outcomes. By using the Norwood Scale to help identify your stage of hair loss, you can help give yourself the best prognosis possible.

Phoenix digital healthcare platform is dedicated to improving the relationship men have with their health. By making it more convenient than ever to complete an online evaluation and have access to treatments sent to your door, you no longer need to sit in waiting rooms or have awkward conversations. Connect with our physicians and customize your treatment plan from the comfort of your home.

References

1. https://my.clevelandclinic.org/health/diseases/24515-male-pattern-baldness-androgenic-alopecia
2. https://www.ncbi.nlm.nih.gov/books/NBK278957/#:~:text=Male%20androgenetic%20alopecia%20(MAA)%20is,vertex%20and%20mid%20frontal%20scalp.
3. https://www.medicalnewstoday.com/articles/327001#stages