Though many people find ways to treat mild forms of baldness, it will likely increase with age.
How a person chooses to cope with hair loss is up to them. Some make adjustments to their treatment in order to keep their full head of hair for as long as possible. Even so, treatment options may not be as successful as the person ages and their hair becomes thinner and weaker.
Others may choose to find more permanent options, such as hair transplants. Other people may decide to wear hair pieces or head garments to cover up their baldness.
Some choose to shave their head entirely, instead of seeking treatment.
It is important to remember that male pattern baldness is a normal part of aging and not something to be embarrassed about or ashamed of.
Summary
Balding and hair loss are very common, especially as people get older.
Understanding the Norwood scale and which stage of male pattern baldness a person is at can help them work with doctors to discover the best treatment options.
There are a number of treatment options available to help treat male pattern baldness, and the results of each can vary from person to person.
Scientists originally developed minoxidil Trusted Source to treat high blood pressure. Its developers found that it had the side effect of excessive, unwanted hair growth.
This effect gave drug companies reason to consider it for male baldness.
Researchers do not know exactly how minoxidil works. The drug appears to widen the hair follicle, which causes a thicker strand of hair to grow.
In addition, minoxidil appears to prolong the growth period of hair, which results in longer hair and a higher number of hair strands. When used properly, minoxidil has been shown to be safe and effective.
It is more effective in individuals who are under 40 years of age.
A 2019 reviewTrusted Source notes that topical minoxidil is only approved by the Food and Drug Administration (FDA) for the treatment of androgenetic alopecia in males and females. However, minoxidil is used off-label for other hair disorders, such as alopecia areata, scarring alopecia, and hair shaft disorders.
The FDA Trusted Source notes that the term “off-label” refers to approved medications that doctors prescribe for unapproved uses.
Minoxidil can cause some side effects, includingTrusted Source:
Hair shedding
Skin irritation and redness
Itchy, yellow, or white scales on the scalp allergic contact dermatitis
Excessive hair growth over the body, including on the face in some females
Minoxidil is also not suitable for people who are pregnant or breastfeeding, or for those who have a hypersensitivity to the ingredients in this medication.
There are a number of things a person can do to promote healthy hair growth, including:
Eating a healthful diet:Â Eating a healthful diet that includes a wide variety of vegetables, fruits, and iron-rich foods ensures that the body gets all the nutrients it needs to create healthy hair.
Using a hair loss shampoo: Some shampoos contain ingredients designed to help remove dandruff and other particles from the pores. This may help keep the pores clear and prevent blockages that could influence hair loss.
Massaging the scalp:Â Massaging the scalp regularly may increase blood circulation in the area, helping keep the follicles healthy. This may also help clear away dandruff and prevent blockages.
Stopping smoking: An older studyTrusted Source suggests that there could be a link between smoking and hair loss.
Avoiding coloring or treating the hair with chemicals:Â Chemicals may make the hair weaker and more prone to breakage and thinning.
Hair loss prevention and treatment go hand in hand.
People begin balding at a wide range of different ages and lose hair at very different speeds, so it’s up to you to decide when to start taking preventive action.
Hair loss treatments like minoxidil and finasteride work to prevent hair loss in most men.
The Norwood scale is a tool that you and your doctors can use to measure the extent of male pattern baldness.
In the early stages, hair loss can be treated with medications. In the later stages, there are several surgical options.
Male pattern hair loss is caused by a combination of genetic, hormonal, and environmental factors.
Your genes, inherited from both your parents, determine your sensitivity to hormones called androgens, particularly one called dihydrotestosterone (DHT).
Each strand of hair begins in a hair follicle and normally grows for two to six years before going into a resting phase and falling out.
When the follicle begins to grow a new hair, the cycle starts again.
Increased androgens in the hair follicles can lead to shorter cycles of hair growth, lasting just weeks or months.
DHT stimulates the process of miniaturization, which causes new hairs to grow shorter and thinner than before.
Eventually, the hair follicles become too small to produce new hairs.
Hair loss treatments are most successful when started early. It’s easier to slow down hair loss than it is to stimulate new hair growth. Hair follicles that stop producing hair become dormant after about two years and can’t be reactivated. Once significant hair loss has occurred, surgical procedures may be the best option.
Over-the-counter (OTC) treatments
Treatments available without a prescription include:
Minoxidil. Applied directly to the scalp, this medication (sold under the brand name Rogaine) can stop hairs from getting thinner. It can also stimulate hair growth on the top of the scalp. It can be combined with other treatments.
Laser devices. There are various brushes, combs, and other devices that release laser light and are marketed as hair loss treatments. These devices might stimulate hair growth, but they haven’t been clinically proven to do so.
Prescription treatments
Depending on the severity of your hair loss and your success with OTC treatments, your doctor may recommend the prescription drug finasteride (Proscar, Propecia). Finasteride is a pill that’s approved by the U.S. Food and Drug Administration to treat men with hair loss. According to the American Academy of Dermatology, it slows hair loss in about 88 percent of men and stimulates regrowth in about 66 percent of men.
Procedures
There are also medical procedures available for the treatment of hair loss, including:
Hair transplantation. Parts of your scalp that have good hair growth are removed, and hair follicles are transplanted to the balding areas.
Scalp reduction. Some of the bald scalp is surgically removed, and the parts of the scalp with good hair growth are brought closer together. This can be combined with a hair transplant.
Scalp expansion. Devices are inserted under the scalp for about three to four weeks to stretch the skin. This procedure may be done before a scalp reduction or as a stand-alone treatment.
Scalp micropigmentation. Tiny tattoos can be applied to the scalp to create the appearance of a shaved head.
The Norwood scale helps classify the stages of male pattern baldness on a scale of 1 to 7. People experiencing male pattern baldness tend to lose hair in one of a few specific ways, and the Norwood scale also helps identify the progression of these patterns of hair loss.
Knowing this can help doctors make an accurate diagnosis and identify the best treatment options for each individual. Some doctors may use their own scales, though they tend to be similar to the Norwood scale.
Keep reading to learn more about the stages of the Norwood scale, some treatments for male pattern baldness, and tips on hair health and how to cope with hair loss.
The Norwood scale has seven stages. Each stage measures the severity and pattern of hair loss.
Stage 1. No significant hair loss or recession of the hairline.
Stage 2. There is a slight recession of the hairline around the temples. This is also known as an adult or mature hairline.
Stage 3. The first signs of clinically significant balding appear. The hairline becomes deeply recessed at both temples, resembling an M, U, or V shape. The recessed spots are completely bare or sparsely covered in hair.
Stage 3 vertex. The hairline stays at stage 2, but there is significant hair loss on the top of the scalp (the vertex).
Stage 4. The hairline recession is more severe than in stage 2, and there is sparse hair or no hair on the vertex. The two areas of hair loss are separated by a band of hair that connects to the hair remaining on the sides of the scalp.
Stage 5. The two areas of hair loss are larger than in stage 4. They are still separated, but the band of hair between them is narrower and sparser.
Stage 6. The balding areas at the temples join with the balding area at the vertex. The band of hair across the top of the head is gone or sparse.
Stage 7. The most severe stage of hair loss, only a band of hair going around the sides of the head remains. This hair is usually not dense and may be fine.
Norwood class A. The class A variation of the Norwood scale is a slightly different and less common progression of hair loss. The main differences are that the hairline recedes back uniformly, without leaving an island of hair in the middle, and there is no bald area at the vertex. Instead, the hairline progresses directly from front to back.
Hair is made up of keratin, which is a protein produced within the hair follicles on the uppermost layer of the skin. The follicles keep producing new hair cells and push out the old dead cells. The hair that you see on your head are compact strands made of dead keratinized cells.
At any given time, 90% or more of the hair on your scalp keeps growing. No two hairs have the same growth pace. In fact, each hair follicle goes through an entire growth cycle of its own, which is influenced by factors such as age, nutrition, illness, and also ethnicity.
It is because each hair follicle goes through a different growth cycle, that you shed only a certain number of hairs per day. If all the hairs on your head went through the same growth cycle, all your hair would fall off at once.
Between starting to grow and falling off, each strand of hair goes through three stages:
Anagen (Growing Phase) – is the hair growing phase, which can last between two to seven years. At any time, about 80% – 90% of the hairs on your head are in the anagen phase. The hairs in this phase grow from one centimetre to half an inch every 28 days. Your genetics determine the amount of time your hair follicle stays in the anagen phase.
Catagen (Regression Phase) – signals the end of the active growing phase and approximately 1% of the hair is in this phase at any given time. This phase of the hair lasts for around 10 to 14 days.
Telogen (Shedding Phase) – this is a resting phase, at the end of which your hair is released and it falls out, i.e., the resting hair stays in the follicle till it is pushed out by the growth of a new anagen hair. At any given time, 10% – 15 % of all hairs are in the telogen phase. The follicle then remains dormant for 3 months and the whole process recurs again.
Symptoms of hair loss include hair loss in patches usually in circular patterns, dandruff, skin lesions, and scarring. Alopecia areata (mild – medium level) usually shows in unusual hair loss areas, e.g., eyebrows, backside of the head or above the ears, areas the male pattern baldness usually does not affect. In male-pattern hair loss, loss and thinning begin at the temples and the crown and hair either thins out or falls out. Female-pattern hair loss occurs at the frontal and parietal.
People have between 100,000 and 150,000 hairs on their head. The number of strands normally lost in a day varies but on average is 100.
To maintain a normal volume, hair must be replaced at the same rate at which it is lost. The first signs of hair thinning that people will often notice are more hairs than usual left in the hairbrush after brushing or in the basin after shampooing. Styling can also reveal areas of thinning, such as a wider parting or a thinning crown
A substantially blemished face, back and limbs could point to cystic acne. The most severe form of the condition, cystic acne, arises from the same hormonal imbalances that cause hair loss and is associated with dihydrotestosterone production.
Seborrheic dermatitis, a condition in which an excessive amount of sebum is produced and builds upon the scalp (looking like an adult cradle cap), is also a symptom of hormonal imbalances, as is an excessively oily or dry scalp. Both can cause hair thinning.
What causes hair fall?
First, your doctor or dermatologist (a doctor who specializes in skin problems) will try to determine the underlying cause of your hair loss. The most common cause of hair loss is hereditary male- or female-pattern baldness.
If you have a family history of baldness, you may have this type of hair loss. Certain sex hormones can trigger hereditary hair loss. It may begin as early as puberty.
In some cases, hair loss may occur with a simple halt in the cycle of hair growth. Major illnesses, surgeries, or traumatic events can trigger hair loss. However, your hair will usually start growing back without treatment.
Hormonal changes can cause temporary hair loss. Examples include:
You can stop or even reverse hair loss with aggressive treatment, especially if it’s due to an underlying medical condition. Hereditary hair loss may be more difficult to treat. However, certain procedures such as hair transplants can help reduce the appearance of baldness.
Talk to your doctor to explore all your options to lessen the effects of hair loss.
Himanshu Singh 
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