Norwood Scale

Treatment Options Mapped to Every Norwood Stage

February 23, 20266 min read1,200 words

Every Norwood stage has a specific set of treatments that produce the best results. Choosing the wrong treatment for your stage wastes money and time. This guide maps the most effective options to each stage so you can make an informed decision based on where you actually are.

Treatment Overview by Stage

StageGraftsPrimary TreatmentSupporting Treatment
Norwood 10Monitoring onlyFinasteride if family history
Norwood 2800-1,500Finasteride + MinoxidilPRP optional
Norwood 31,500-2,200FUE transplant + FinasterideMinoxidil, PRP
Norwood 3V2,000-2,800FUE transplant + FinasterideMinoxidil, PRP for crown
Norwood 42,500-3,500FUE transplant + FinasteridePRP, Minoxidil
Norwood 53,000-4,500FUE mega-session + FinasterideSecond session, PRP
Norwood 64,000-6,000FUE + FUT combo + FinasterideMulti-session plan
Norwood 75,500-7,500FUT + FUE + body hairStrategic coverage only

Norwood 1: Watch and Prevent

No treatment is required. If you have a strong family history of pattern baldness, consider starting finasteride (1mg daily) as a preventive measure. Track your hairline with photos every 6 months.

Cost: $0 for monitoring. Finasteride runs $10-30/month generic.

Norwood 2: Medication First

Norwood 2 is the ideal stage to start medical treatment. Finasteride halts further loss in 80-90% of men and produces regrowth in about 65%. Minoxidil (5% topical, applied twice daily) adds another layer of protection with 40-60% moderate regrowth visible at 4-6 months.

Most dermatologists advise against surgery at Norwood 2 because:

  • The loss is minimal and may stabilize with medication
  • A transplant now does not prevent future loss in untreated zones
  • You may not need surgery at all if medication works

Exception: If you have had stable Norwood 2 recession for 2+ years despite medication and it bothers you cosmetically, a conservative 800-1,500 graft FUE session can restore the temples.

Monthly cost: Finasteride $10-30 + Minoxidil $15-40.

Norwood 3: Surgery Becomes an Option

This is the minimum stage where most reputable surgeons will perform a transplant. Temple recession is clearly visible, and medication alone cannot restore lost ground.

  1. Start finasteride at least 6-12 months before surgery to stabilize loss
  2. FUE transplant: 1,500-2,200 grafts targeting the temporal recessions
  3. Post-op minoxidil to support graft survival and protect native hair
  4. Optional PRP ($500-2,000/session) for a 30-40% density boost

Surgical Details

  • Technique: FUE with 0.7-1.0mm punches
  • Recovery: 7-10 days before returning to normal activities
  • Graft survival: 90-95% with proper aftercare
  • Final results visible at 12-18 months

Total cost (US): $6,000-13,200 for surgery + ~$50/month medication. Total cost (Turkey): $1,500-4,400 for surgery + medication.

Norwood 3V: Frontal and Crown Need Attention

The vertex variant adds crown thinning on top of temple recession. This increases the total graft count to 2,000-2,800 and requires planning for two distinct zones.

Strategy

  • Allocate roughly 60% of grafts to the frontal/temporal region and 40% to the crown
  • PRP is especially useful for the crown, where diffuse thinning responds well to growth factor stimulation
  • Consider whether the crown can be managed with minoxidil alone while surgery addresses the hairline

Norwood 4: Single Session, Full Plan

At Norwood 4, both the frontal area and crown show significant loss. The bridge of hair connecting them is visibly thinner. A single FUE session of 2,500-3,500 grafts can address most of the loss, but you need a long-term plan.

Critical Planning Points

  • Future-proof the hairline. Design a hairline that still looks natural if you progress to Norwood 5 or 6.
  • Budget donor grafts. With a safe extraction limit of 45% and typical donor supplies of 6,000-8,000 total FUE grafts, you must reserve grafts for potential future sessions.
  • Prioritize the front. The frontal third of the scalp creates the most visual impact. Heavier density here with lighter crown coverage produces the best aesthetic result per graft spent.

Cost per graft: $4-6 (US), $1-2 (Turkey), $3-5 (UK), $2.50-4.50 (Europe).

Norwood 5: Mega-Session Territory

The frontal and crown areas are nearly merged. Coverage requires 3,000-4,500 grafts, which pushes into mega-session territory for FUE.

  • Option A: Single mega-session FUE. Up to 5,000 grafts in one session. Requires a skilled surgical team, longer procedure (8-12 hours), and excellent donor density.
  • Option B: Two sessions spaced 8-12 months apart. First session addresses the frontal zone (2,000-2,500 grafts). Second session addresses the crown (1,000-2,000 grafts). This approach is less taxing on the donor area and allows assessment of first-session results before committing the remaining grafts.

Finasteride is non-negotiable at this stage. Without it, the remaining native hair will continue thinning, undermining surgical results.

Norwood 6: Multi-Method Required

The bridge is gone. A horseshoe band of hair remains on the sides and back. Total graft need is 4,000-6,000, which often exceeds what FUE alone can deliver in a single session.

Best Approach

  • FUE + FUT combination. FUT harvests a strip yielding up to 4,000 grafts from the donor area, while FUE fills in additional zones with 1,000-2,000 grafts from the remaining donor or beard.
  • Minimum 2 sessions spaced 10-12 months apart.
  • Frontal priority. First session focuses entirely on the hairline and frontal third. Second session addresses mid-scalp and crown.

Full Norwood 1 restoration is not realistic at this stage. The goal is a natural-looking density that frames the face effectively.

Norwood 7: Strategic Restoration

The most extensive stage. Only the horseshoe band remains. Total need is 5,500-7,500 grafts, but donor supply limits what is achievable.

Realistic Expectations

  • Full coverage is not possible. Donor supply typically caps at 6,000-8,000 FUE grafts total.
  • Focus on the frontal hairline and the first 3-4cm behind it for maximum visual impact.
  • FUT + FUE + body hair grafts (beard, chest) may be needed to reach adequate graft counts.
  • Multiple sessions (2-3) over 18-36 months.
  • Scalp micropigmentation (SMP) can create the illusion of density between transplanted hairs.

Cost Expectations

RegionCost Per GraftTotal for 6,000 Grafts
Turkey$1-2$6,000-12,000
India$0.50-1.50$3,000-9,000
Europe$2.50-4.50$15,000-27,000
UK$3-5$18,000-30,000
USA$4-6$24,000-36,000

Find Your Treatment Plan

Upload a photo at myhairline.ai/analyze to identify your Norwood stage and get a treatment recommendation matched to your level of loss. For graft counts broken down by hairline, temples, mid-scalp, and crown, use the graft calculator by zone. For a full explanation of each stage, read the Norwood scale guide.

Frequently Asked Questions

Norwood 1-2: prevention with finasteride and minoxidil. Norwood 3-4: medication plus a single FUE session (1,500-3,500 grafts). Norwood 5-6: multi-session transplant (3,000-6,000 grafts) with medication. Norwood 7: FUT + FUE combination (5,500-7,500 grafts) focused on frontal framing.

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