Norwood & Ludwig

Hair loss stages: where are you?

Doctors classify hereditary hair loss in stages: the Norwood scale (1 to 7) for men and the Ludwig scale (I to III) for women. Your stage determines which treatment makes sense and how many grafts a transplant needs.

Men: Norwood scale

The Norwood-Hamilton scale describes how receding temples and crown loss spread and eventually merge.

Drawing of the Norwood scale showing stages I to VII of male pattern hair loss — The Norwood scale divides male pattern hair loss into seven stages, plus variants (A types, vertex). Image: Keministi, Wikimedia Commons, CC0

Chart: grafts needed per Norwood stage — Chart: HaarVergleich.ch, CC BY 4.0 (free to use with a link to the source). Guide values from the literature and clinics

Norwood 1

No visible recession

No transplant

The hairline is fully intact or has receded only minimally. This is the juvenile hairline, which in most men shifts back slightly from the early twenties (mature hairline).

Norwood 2

Slightly receding temples

800–1,500 Grafts

Slight, symmetrical recession at the temples. The hairline moves back by about 1 to 2 cm; the middle of the forehead is still full.

Norwood 3

Clearly receding hairline

1,500–2,200 Grafts

Deep, clearly receding temples. This is the first stage considered cosmetically significant hair loss. The middle of the forehead often forms an island.

Norwood 3V

Temples plus early crown loss

2,000–2,800 Grafts

Receding temples as in stage 3, plus early thinning at the crown (vertex).

Norwood 4

Deep temples, visible crown

2,200–3,200 Grafts

Deep temples and a visible bald spot at the crown, still separated by a band of dense hair.

Norwood 5

Bridge of hair thinning

3,000–4,000 Grafts

The band between front and crown becomes thin; the bald areas start to merge.

Norwood 6

Top of the head bald

4,000–5,000 Grafts

The top is bald and the bridge between front and back is gone. A wide horseshoe of hair remains on the sides and back.

Norwood 7

Only a horseshoe fringe left

5,000–6,500 Grafts

Only a narrow fringe remains on the sides and at the nape, often thinner too.

Women: Ludwig scale

In women the parting thins first, while the frontal hairline usually stays intact.

Drawing of the Ludwig scale showing three grades of thinning on top of the head in women — The Ludwig scale: in women, hair usually thins along the parting while the hairline stays intact. Image: Keministi, Wikimedia Commons, CC0

Chart: grafts needed per Ludwig grade in women — Chart: HaarVergleich.ch, CC BY 4.0 (free to use with a link to the source). Guide values from the literature and clinics

Ludwig I

Slightly wider parting

800–1,500 Grafts

The parting widens slightly and the scalp shows in bright light. The frontal hairline is preserved.

Ludwig II

Clearly thinning parting

1,500–2,500 Grafts

The parting is clearly wider and hair on top noticeably thinner. The scalp is visible in normal light.

Ludwig III

Diffuse thinning on top

2,500–3,500 Grafts

The top is diffusely thin to bald; the front hairline usually remains.

Frequently asked questions

What is the Norwood scale?

The Norwood-Hamilton scale classifies male pattern hair loss in 7 stages, from a slightly receding hairline (stages 1–2) to deep temples (3), crown loss (3V–4) and finally only a fringe of hair (7).

At what Norwood stage is a hair transplant worthwhile?

Usually from stage 3, when the temples have clearly receded. A small correction is possible at stage 2, but young men should first wait and slow the loss with medication.

How many grafts do I need at Norwood 3?

Typically 1,500 to 2,200 grafts; at Norwood 3V with early crown loss 2,000 to 2,800.

What is the Ludwig scale?

The Ludwig scale describes female hair loss in three grades, from a slightly wider parting (grade I) to diffuse thinning on top (grade III).