The 7 stages of balding and how to treat each phase

Around 70% of men will lose their hair as they age, so here's how to treat hair loss at any stage.

Written by
Imogen Kars
Medically reviewed by
Last updated
May 26, 2022
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It might be the last thing you want to talk about but male pattern baldness is an extremely common and often stress-inducing situation that happens to a lot of men.

In fact, around 70 per cent of men will lose their hair as they age.

Male pattern hair loss happen generally overnight though. It usually occurs gradually over the course of a few years or decades — meaning there's plenty of time to come to terms with it or even treat it.

As the most common type of hair loss in men, male pattern baldness follows a strict pattern or series of stages of balding that usually begins with an innocent receding hairline.

In the late stages of balding, treatment options are much further and fewer between.

Waiting to treat baldness can result in significant hair loss, so getting to know the green flags of healthy hair growth and the red flags of hairline recession is a great first step to stopping hair loss in its early stages.

And, treating male pattern baldness is as easy as doing an online assessment with Pilot, where one of our Australian doctors will create a personalised hair loss treatment plan for you, which is then shipped to your door in discreet packaging.

If you're keen to keep your head of hair, it's wise to get close and comfortable with the stages of male pattern baldness.

Although balding is extremely normal and commonplace, there's also no shame in staying on top of your hair loss and seeking treatment to change this.

Employing medically-backed remedies to keep your hair and encourage hair growth can hugely impact your self-esteem and mental health, so don't feel embarrassed for addressing the situation.

Now, let's dive into everything you need to know about the stages of balding.

Introducing the Norwood scale

Let's start off by saying that it's not all doom and gloom when it comes to hair loss because male pattern baldness is an extremely common occurrence in many men and a system called the Norwood scale was developed to support men in assessing their hair loss.

Giving men around the globe the tools to monitor their hair loss and stop further hair loss, the Norwood scale (also known as the Hamilton-Norwood scale classification system) was developed in the 1950s by James Hamilton.

Later revised in 1975 by dermatologist Dr. O'Tar Norwood — who split the male pattern baldness into seven distinct stages — the Norwood scale is a great tool that helps men gauge how severe their hair loss is.

But before we dive into the actual stages of balding in the Norwood scale, it's important to understand the science behind hair loss.

Caused by a combination of your genes and a hormone in your body called dihydrotestosterone, or DHT, male pattern baldness doesn't happen overnight — even when you're 100 per cent sure that bald patch wasn't there yesterday!

DHT is a byproduct of testosterone — and over time, it can bind to the receptors in your scalp and shrink or miniaturise your hair follicles, preventing new hair growth.

The hair loss usually starts at your hairline before moving on to the rest of your scalp making male pattern baldness difficult and frustrating to keep track of — that is, without the Norwood scale.

Covering every major stage of hair loss, the Norwood scale can help men determine how severe their hair loss is. In the early stages of balding, the easier it is to find hair loss treatments that work and prevent further balding areas.

The 7 stages of hair loss

Now you know the science behind male pattern baldness, let's dive into the seven stages of balding according to the Norwood scale.

Stage 1: Mild and often unnoticeable hair loss around the temples

Stage one is a great place to be as it means you've experienced minimal hair loss to the hairline and barely any loss to the rest of the head. In fact, some men can stay in this phase for most of their lives — it is uncommon but it does happen.

At this stage, there's not much you really need to be doing to treat hair loss. Although if you're really concerned that hair loss is in your future as you might be genetically predisposed — look around at your family members and see what their hair looks like for context — it can be worth investigating hair loss prevention methods.

Instead, you might want to focus on your lifestyle and cleaning up your habits to encourage healthy and happy hair follicles.

To start, quitting smoking can be incredibly helpful as it's been shown to damage hair follicles and lead to hair loss.

Next on the list is to maintain a healthy diet full of vitamins and minerals. Studies show that deficiencies in nutrients like iron, protein and essential fatty acids can contribute to male pattern baldness.

And lastly, try to manage your stress levels as best you can. Stress can trigger hair loss in certain cases so implementing stress management strategies will be helpful, or consider seeking professional treatment if you need support.

Stage 2: Hair thinning and the M-shaped hairline

When your baldness begins to form a triangular shape across the hairline, stage two has pulled up a seat. While it's still a fairly mild stage of balding, hair loss is certainly visible.

Your hairline may have receded near your temples and sideburns — some men say this gives the hairline a backwards-sloping look when viewed from the side of your face.

Otherwise, when viewed from above it may look like a V or an M shape.

Coined as front baldness, stage two signals a wider forehead with more visible temples. It can also trigger the thinning of the crown, and although most of it remains unnoticeable to the untrained eye, this is a good time to seek treatment if you're worried.

You have a far better chance of keeping your hair when you start treating the hair loss in the early stages, so now is a great time to do your online assessment with Pilot.

Stage 3: Visible balding, hairline recession and prominence of M, U or V shapes

Here's where things get a little trickier. At stage two, preventing further hair loss is a little easier but stage three can present a few more difficulties.

At this stage, your balding will usually be more noticeable. Your hairline will have receded deeper and your forehead will further widen to create M, U or V shapes.

Where stages one and two were coined as mild hair loss, stage three is where the real hair loss starts. In fact, the Norwood scale refers to stage three as the first stage of baldness.

Some men begin to show bald spots, and the crown of the head progressively becomes thinner.

Stage 4: Significant hair loss at the back of the head

Known on the Norwood scale for being more severe and more obvious than the previous stages of balding, stage four will often see men with only a thin ring of hair or no hair on the vertex scalp or crown.

It's also very common for men at stage four to have a thick band of hair separating their hairline from the balding areas on the crown.

Large bald patches begin to show at the back of the head, and at this stage, hair loss progresses.

Stage 5: Horseshoe or U-shaped hairline

At this stage of balding, you most likely will have lost a lot of hair.

Signalling the presence of a horseshoe-shaped hairline, this stage is where things can get a little difficult to treat so if you're wanting to treat the hair loss, it's worth doing that now.

During stage five of male pattern hair loss, the band of hair separating your hairline becomes thinner and less noticeable.

Stage 6: Visible scalp and large bald patches

As a very severe form of hair loss, stage six will see men having lost almost all of the hair that made up their hairline and vertex scalp.

Although there may be a thin band of hair that separates the areas, it's not necessary to signify stage six. Some thin hair may still exist on the scalp, but coverage is generally minimal and the scalp is very visible.

A horseshoe pattern in the hairline usually occurs, leading to the back and sides of the head being easy to see.

Stage 7: Hairline receded to the crown

As the most severe form of male pattern hair loss, stage seven is synonymous with having almost no hair. There may be a few stray hairs or small areas of mild hair growth that remain, but generally, the scalp will be completely bare.

At this stage, the thinning strip of hair that forms a horseshoe pattern may remain, but it will be extremely fine.

At what age does balding commonly start?

While most instances of severe hair loss occur in older men, male pattern hair loss can happen at almost any age starting from puberty.

When and how much hair you lose is completely dependent on your genetics, your lifestyle and your environmental factors but the likelihood definitely increases with age.

Unfortunately for some men, hair loss can begin as early as 15 or 16 years of age. This is uncommon, but for some males with genetically predisposed baldness, a receding hairline can create issues from day dot.

Losing your hair at this age can be extremely difficult and could even signal a deeper health issue so make sure to contact a trusted health professional if you begin to experience severe hair loss while you're still at school.

How is male pattern baldness diagnosed?

If you're experiencing the signs and stages of male pattern hair loss and you want to address it, now is the time to start working with a doctor.

For most men, contacting a medical professional in the early stages of balding is the best way to ensure a solution — it's far easier to encourage hair growth in the first few stages of the Norwood scale, and much harder towards the end.

But, no matter where you fall on the scale, it's worth doing an online assessment with Pilot so our Australian doctors can determine what stage of hair loss you're at and how to tackle it.

How to treat hair loss

Thankfully, if you use the Norwood scale and are aware of the early stages of balding, hair loss is often very treatable.

Pilot's personalised hair loss treatment plans are designed by Dr. Russel Knudsen, who has over 35 years of experience in treating male pattern baldness and over 80 per cent of men who use this treatment keep their hair.

Start treating your hair loss today.

Photo Credit: NBC

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