Norwood Classification of Hair Loss in Men
It’s no more under the wraps that men with a receding hairline are on the verge but reliable path to baldness, although most of the men must be capable to sustain a decent fallen halo of hair at the back and around the sides.
Male pattern baldness is a stereotypical hair loss diagnosis in men. As a set rule it begins at both the temples then crown of the scalp and then progresses over time, the two thinning areas eventually meet. The deceitful relationship may have appeared to hop from nowhere but according to Dr. O’Tar Norwood it was an inevitable connection just marking time to blossom.
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|Class I||Represents an adolescent or juvenile hairline and is not actually balding. The adolescent hairline generally rests on the upper brow crease.|
|Class II||Indicates a progression to the adult or mature hairline that sits a finger’s breath (1.5cm) above the upper brow crease, with some temporal recession. This also does not represent balding.|
|Class III||The earliest stage of male hair loss. It is characterized by a deepening temporal recession.|
|Class III Vertex||Represents early hair loss in the crown (vertex).|
|Class IV||Characterized by further frontal hair loss and enlargement of vertex, but there is still a solid band of hair across the top (mid-scalp) separating front and vertex.|
|Class V||The bald areas in the front and crown continue to enlarge and the bridge of hair separating the two areas begins to break down.|
|Class VI||Occurs when the connecting bridge of hair disappears leaving a single large bald area on the front and top of the scalp. The hair on the sides of the scalp remains relatively high.|
|Class VII||Patients have extensive hair loss with only a wreath of hair remaining in the back and sides of the scalp.|
The Norwood Scale by Dr. O’Tar is a set of images that portrays the different stages of male pattern hair loss. Now, whether they attempt to ignore the condition or not, most men know what to anticipate when they notice the early signs of hair loss, so what’s the point of such images or classification diagram that only depicts the obvious?
Well, the degree at which men lose hair varies tremendously. Male pattern hair loss can take its toll as early as puberty and while some men may fall out excessive hair rapidly in their mid 20’s up to a Type 3 or Type 4, others may have no traceable rate of hair loss until they enter their 50’s, only to progress to a Type 6 or Type 7 in merely a few years.
Importantly, the scale is used to evaluate how advanced a man’s hair loss is. This indicates that the higher the shed count, the more advanced the loss. And if a man begins to thin, bald or recede early in life, there are chances that you are destined to lose quite a bit of hair. Norwood explains the 7 stages of hair loss in men.
So, estimate yourself of how bald are you with this Norwood’s scale
Type I – Slightest hair loss with minimum damage to follicles
Type II – Hair loss occurs at the temples.
Type III – This is the primary stage of hair loss that needs treatment.
Type III vertex – Thinning of hair on the vertex along with receding hairline.
Type IV – Much larger pattern grows on the vertex and hairline.
Type V – Balding Patterns at both sites are larger but a thin division line still exists
Type VI – The Bridge goes away but few strands of short, fine hair are still present.
Type VI – This is the stage of most severe hair loss. Only a few hairs on the top or front of the head remain in this phase.
Diffuse Patterned and Unpatterned Alopecia
Male pattern hair loss is also caused due to genetic predisposition and hormonal imbalances. Two types of hereditary hair loss commonly found in men but not often contemplated by doctors, “Diffuse Patterned Alopecia” (DPA) and “Diffuse Unpatterned Alopecia,” (DUPA). The two hair loss condition presents a big challenge both in diagnosis as well as in patient management. Having a proper understanding of these conditions is essential to the analysis of hair loss in both men and women, specifically those that are young when the diagnosis may be easily neglected, as they may carry out that the patient is not a candidate for surgery.
Diffuse Patterned Alopecia (DPA) is an androgenetic alopecia demonstrated as diffuse thinning on the top, crown and in the front, with a stable permanent zone. In DPA, the complete top of the head slowly and successively miniaturizes without even going through the classic Norwood stages module.
Diffuse Unpatterned Alopecia (DUPA) is also an androgenetic form of hair loss, but lacks a stable permanent zone and targets males much less often than DPA. DUPA has a tendency of rapid progression as compared to DPA and finishes as a horseshoe pattern resembling the Norwood class VII. However, unlike the Norwood VII, the DUPA horseshoe can be seen as almost sheer because of the low density of the sides and back.
Establishing a significant differentiation between DPA and DUPA is quite crucial because DPA patients often qualify as ideal transplant candidates, whereas DUPA patients merely or almost never do, as they eventually have severe hair loss without a stable permanent zone for planting follicles.
|Class II A||Loss of frontal hairline|
|Class III A||Loss of frontal hairline and front part of frontal-scalp|
|Class IV A||Loss of hair in the entire frontal scalp|
|Class V A||Loss of hair in front and mid-scalp|