Men’s Hair Loss Explained - Stages, Solutions, and When to Act

November 2, 2024

Men’s Hair Loss Explained - Stages, Solutions, and When to Act

Hair loss is a common concern for many men, often leading to a search for effective solutions. It’s important to understand how baldness progresses when deciding the right approach to address it. Dermatologists and hair specialists typically rely on established scales to assess the stages of hair loss, with the Norwood-Hamilton scale being the standard for men, and the Ludwig scale for women.

The Norwood-Hamilton scale is a systematic way to classify male pattern baldness. This scale lays out seven stages of hair loss, ranging from a full head of hair to complete baldness. It is recognised worldwide for its accuracy in diagnosing androgenetic alopecia, the most common form of hair loss in men.

Stages of the Norwood-Hamilton Scale

  1. Stage 1: Full Hair Coverage At this initial stage, there are no visible signs of hair loss. Men may have varying hairline heights, but this is not necessarily an indication of future baldness.
  2. Stage 2: Mild Hairline Recession This stage marks the beginning of noticeable hair loss, especially around the temples. While a receding hairline may be apparent, intervention is typically not recommended yet.
  3. Stage 3: Significant Balding At this point, men may notice substantial thinning at the crown or vertex, as well as further recession of the frontal hairline. Treatments like PRP (Platelet-Rich Plasma) and laser therapy may be considered to slow the progression.
  4. Stage 4: Advanced Hair Loss Significant baldness becomes obvious, with little hair remaining on the top of the head, save for a band connecting the sides. This stage often requires more serious intervention.
  5. Stage 5: Very Advanced Baldness While there is minimal hair left on the crown, hair remains on the sides and back. This stage often leads to consideration for a hair transplant.
  6. Stage 6: Severe Balding At this stage, the crown is completely bald, but a strip of hair remains around the sides. This band may serve as a donor area for transplants.
  7. Stage 7: Extreme Baldness This final stage is characterised by a completely bald top of the head, with only sparse hair remaining on the sides and back.

When to Consider a Hair Transplant

For those contemplating having a hair transplant, timing is key. At Tir na nOg Clinic, Dr Kevin McDonald typically advises against transplant surgery at stage 3 due to the uncertainty of future hair loss. Ideally, candidates should consider a hair transplant starting from stage 4, when the hair loss pattern is more predictable. People at stage 5 or 6 are generally the best candidates for Follicular Unit Excision (FUE) transplants, which can restore coverage to earlier stages.

Candidates are generally recommended to be at least 30 years old, as hair loss patterns tend to stabilise around this age, but it is not unusual for men in their 20s to be eligible also. For individuals under 30, non surgical treatments are often suggested first to manage hair loss before considering surgery.

Once, after an in person consultation,  Dr Kevin has deemed a patient to be suitable for surgery, an appointment for FUE will be arranged. FUE  is a minimally invasive hair transplant method that extracts healthy hair follicles from donor areas, usually at the back or sides of the head, and transplants them to thinning areas. The recovery is generally quick, with most patients resuming normal activities within one to two weeks.

A successful hair transplant greatly depends on the stability of hair loss. If the hair continues to thin after a transplant, it can lead to uneven results, requiring additional procedures. Therefore, Dr Kevin always advises waiting until hair loss has stabilised for a satisfactory and lasting outcome.

Understanding the progression of hair loss through the Norwood-Hamilton scale can empower people to make informed decisions about the treatment options available to them. Whether considering non surgical solutions or a hair transplant, it’s important to consult with experienced hair transplant surgeons who can tailor a strategy to each patient’s specific needs. Remember, early intervention can make a significant difference in managing hair loss effectively.