At Norwood 5, hair transplant surgery combined with medical therapy is the most effective treatment path. The extensive hair loss at this stage (continuous baldness from the frontal hairline through to the crown) is beyond what medication alone can reverse. However, a well-planned surgical procedure of 3,000 to 4,500 grafts, supported by finasteride and minoxidil, can produce a visible, natural restoration.
This article is for informational purposes only and does not constitute medical advice. Consult a qualified hair loss specialist before making any treatment decisions.
Option 1: FUE Hair Transplant (Follicular Unit Excision)
FUE is the most widely performed transplant technique globally and is well-suited to Norwood 5. Individual follicular units are extracted from the donor area using a 0.7 to 1.0 mm circular punch, then implanted into the recipient zones.
Norwood 5 specifics:
- Graft range: 3,000 to 4,500 (achievable in a single mega-session of up to 5,000 grafts)
- Recovery: 7 to 10 days before returning to normal activities
- Graft survival: 90-95% in experienced hands
- Scarring: Scattered dot scars across the donor area, invisible at most hair lengths
- Cost per graft: $1-2 (Turkey), $2.50-4.50 (Europe), $3-5 (UK), $4-6 (US), $0.50-1.50 (India)
FUE is the preferred option for patients who wear their hair short, want to avoid a linear scar, or need a high graft count in a single session. At Norwood 5, a 4,000-graft FUE session takes approximately 8 to 10 hours.
Option 2: FUT Hair Transplant (Follicular Unit Transplantation)
FUT removes a strip of scalp from the donor area, which is dissected under microscopy into individual follicular units. The donor wound is closed with sutures, leaving a linear scar.
Norwood 5 specifics:
- Graft range: up to 4,000 per session (covers most Norwood 5 cases)
- Recovery: 10 to 14 days (longer than FUE due to the sutured wound)
- Graft survival: 90-95%
- Scarring: Linear scar (typically 1 to 3 mm wide when healed), visible only at very short hair lengths
- Cost: Generally 10-20% less than FUE
FUT can be advantageous at Norwood 5 because the microscopic dissection produces high-quality grafts with minimal transection. Patients who keep their hair at medium lengths and prioritize cost efficiency may prefer FUT.
Option 3: DHI Hair Transplant (Direct Hair Implantation)
DHI uses Choi implanter pens to extract and place grafts without pre-made recipient incisions. The technique provides precise control over graft angle, depth, and direction.
Norwood 5 specifics:
- Graft range: up to 3,500 per session (Norwood 5 patients needing 4,000+ grafts may require two sessions)
- Recovery: 7 to 10 days
- Graft survival: 90-95%
- Scarring: Similar to FUE (dot scars)
- Cost per graft: Typically 20-30% higher than FUE
DHI's session limit of 3,500 grafts means some Norwood 5 patients will need a second session 6 to 12 months later. The technique excels in hairline refinement, where precise angle control matters most. For a detailed breakdown of how many grafts Norwood 5 requires, see Norwood 5 graft requirements.
Option 4: Finasteride (Oral Medication)
Finasteride 1 mg daily is not a standalone treatment at Norwood 5, but it is an essential supporting therapy before and after surgery.
What finasteride does at Norwood 5:
- Halts further progression in 80-90% of men by blocking DHT production
- Produces visible regrowth in approximately 65% of users (primarily in areas where follicles are miniaturized but not dead)
- Takes 6 to 12 months for visible results
- Must be taken continuously
- Side effects: sexual side effects in 2-4% of users, typically reversible on discontinuation
- Monthly cost: $20 to $50
Starting finasteride before surgery stabilizes the hair loss pattern, and continuing after surgery protects native hair from further thinning. At Norwood 5, this protection is critical because any additional loss in the residual hair band would increase the area requiring surgical coverage.
Option 5: Minoxidil (Topical or Oral)
Minoxidil complements finasteride through a different mechanism. Available as a 2% or 5% topical solution, or as low-dose oral medication (0.25 to 2.5 mg daily, by prescription).
What minoxidil does at Norwood 5:
- Produces moderate regrowth in 40-60% of users
- Most effective on the crown and mid-scalp areas
- Onset: 4 to 6 months for visible results
- Must be used continuously
- Monthly cost: $15 to $40
The finasteride-plus-minoxidil combination is the gold standard medical protocol at any Norwood stage and should be maintained indefinitely after a transplant.
Option 6: PRP Therapy (Platelet-Rich Plasma)
PRP involves concentrating growth factors from the patient's blood and injecting them into the scalp. It supports both native hair and transplanted grafts.
At Norwood 5:
- 3 to 4 initial sessions spaced 4 to 6 weeks apart, then quarterly maintenance
- Cost: $500 to $2,000 per session
- Studies show a 30-40% increase in density in treated areas
- Best as an adjunct to surgery and medication, not a standalone treatment
PRP is particularly useful in the first year after transplant, when it may improve graft survival and native hair density around the surgical zone.
Option 7: Scalp Micropigmentation (SMP)
SMP is a non-surgical option that creates the appearance of a close-shaved or buzz-cut hairstyle by tattooing tiny dots on the scalp. It does not grow actual hair but can create a convincing visual illusion of density.
At Norwood 5:
- Requires 2 to 4 sessions over several weeks
- Cost: $2,000 to $5,000 for full scalp coverage
- Lasts 3 to 6 years before fading requires touch-up
- Can be combined with a hair transplant (SMP fills in between transplanted hairs for added visual density)
- No recovery time
SMP is a practical option for Norwood 5 patients who cannot afford or do not want surgery but still want a cosmetic improvement. It is also useful for patients with limited donor supply who want to enhance the visual impact of a lower graft count.
Option 8: Hair Systems (Non-Surgical Hair Replacement)
Modern hair systems (custom-made hairpieces) have improved significantly and can provide a full head of hair appearance without surgery.
- Cost: $200 to $800 per system, replaced every 2 to 4 months
- Maintenance: regular adhesive changes, washing, and styling
- Provides immediate visual transformation
- Requires ongoing commitment and cost
Hair systems are a reasonable option for Norwood 5 patients who are not surgical candidates (due to low donor density or health contraindications) or who want immediate results while considering surgery.
Comparing Treatment Options at Norwood 5
| Treatment | Visible Restoration | Evidence Level | Approximate Cost | Maintenance |
|---|---|---|---|---|
| FUE transplant | High | High | $3,000-$27,000 | Minimal |
| FUT transplant | High | High | $2,400-$20,000 | Minimal |
| DHI transplant | High | High | $4,500-$31,500 | Minimal |
| Finasteride | Low (supportive) | High | $240-$600/year | Daily pill |
| Minoxidil | Low-Moderate | High | $180-$480/year | Daily application |
| PRP | Low-Moderate | Moderate | $1,500-$8,000/year | Quarterly |
| SMP | Moderate (cosmetic) | N/A | $2,000-$5,000 | Touch-ups every 3-6 years |
| Hair system | High (cosmetic) | N/A | $1,000-$3,200/year | Ongoing |
Building a Treatment Plan at Norwood 5
The strongest approach at Norwood 5 follows this sequence:
- Confirm your Norwood stage. Upload a photo at myhairline.ai/analyze for a free AI assessment.
- Start finasteride and minoxidil. Begin 6 to 12 months before surgery if possible.
- Consult 2 to 3 surgeons. Compare graft counts, techniques, and pricing.
- Undergo the transplant procedure (3,000 to 4,500 grafts, technique based on your case).
- Continue finasteride and minoxidil indefinitely after surgery.
- Add PRP sessions in the first year to support graft survival and native hair.
- Evaluate at 12 to 18 months whether a touch-up session for crown density is needed.
For a full overview of Norwood 5 characteristics, see what Norwood 5 looks like and the complete Norwood scale guide.
FAQ
What is the best treatment for Norwood 5?
The most effective approach at Norwood 5 combines a hair transplant (FUE, FUT, or DHI using 3,000 to 4,500 grafts) with ongoing finasteride and minoxidil. Surgery restores visible coverage while medication protects remaining native hair and supports graft survival. PRP therapy is a useful adjunct for maximizing density.
Can medication alone treat Norwood 5?
Medication alone cannot restore the extensive bald areas at Norwood 5. Finasteride and minoxidil can slow further progression and modestly thicken remaining hair, but the frontal and crown areas that have been bare for years are beyond the reach of medical therapy. Surgery is required for visible restoration at this stage.
How much does Norwood 5 treatment cost?
A Norwood 5 hair transplant costs between $3,000 and $27,000 depending on country and technique. Turkey ranges from $3,000 to $9,000, the UK from $9,000 to $22,500, and the US from $12,000 to $27,000. Annual medication costs (finasteride plus minoxidil) add $420 to $1,080. PRP sessions cost $500 to $2,000 each.