| Hair loss and male pattern baldness can be a | | | | vertex. |
| rather intimate issue for men of all ages. The fact | | | | Class V - |
| that there are several different types of hair loss | | | | In the fifth class, the bald areas in the front and |
| complicated the issue when treatments are being | | | | crown continue to enlarge and the bridge of hair |
| considered. This is especially true with over the | | | | separating the two areas begins to break down. |
| counter treatments for baldness, including Minoxidil | | | | Class VI - |
| and Finasteride. | | | | Class VI occurs when the connecting bridge of |
| The Norwood Classification System - | | | | hair disappears, leaving a single large bald area on |
| In 1975, Dr. O'tar Norwood established the | | | | the front and top of the scalp. The hair on the |
| Norwood classification system for identifying the | | | | sides of the scalp remains relatively high. |
| different types and phases of balding in men. The | | | | Class VII - |
| Norwood system is the most widely used | | | | Patients in the final Norwood class have extensive |
| classification for hair loss in men, and is used by | | | | hair loss with only a wreath of hair remaining in |
| most hair restoration surgeons in determining the | | | | the back and sides of the scalp. |
| proper action to address balding. It defines two | | | | Norwood Class A - |
| major patterns of baldness and several less | | | | Separate from the 7 classes mentioned above, |
| common types. In the regular Norwood pattern, | | | | the Norwood Class A patterns are characterized |
| two areas of hair loss -- a bitemporal recession | | | | by a front to back progression of hair loss. |
| and thinning crown -- gradually enlarge and | | | | Norwood Class A's lack the connecting bridge |
| coalesce until the entire front, top and crown | | | | across the top of the scalp and generally have |
| (vertex) of the scalp are bald. There are seven | | | | more limited hair loss in the crown, even in |
| classes of hair loss in the Norwood classification | | | | advanced stages. |
| system. | | | | Norwood Class A patterns are far less common |
| Class I - | | | | in most men than the regular pattern (less than |
| The first Norwood class for male hair loss | | | | 10% of adult men). These patterns are still |
| represents an adolescent or juvenile hairline and is | | | | deemed significant because of the fact that, since |
| not actually considered "balding." The adolescent | | | | the hair loss is most dramatic in the front, the |
| hairline generally rests on the upper brow crease. | | | | patients look very bald even when the hair loss is |
| Class II - | | | | minimal. |
| The second class indicates a progression to the | | | | Because the frontal bald area is not generally |
| adult or mature hairline that sits a finger's breath | | | | responsive to medication, men with Class A hair |
| (1.5cm) above the upper brow crease, with some | | | | loss often seek surgical hair restoration early. |
| temporal recession. This also does not represent | | | | Additionally, the dense donor area contrasts and |
| balding. | | | | accentuates the baldness on top. Fortunately, |
| Class III - | | | | Class A patients are excellent candidates for hair |
| Norwood class III is the earliest stage of male hair | | | | transplantation. |
| loss. It is characterized by a deepening temporal | | | | Male Pattern Baldness: Diffuse Patterned and |
| recession, commonly referred to as a receding | | | | Unpatterned Alopecia - |
| hairline. | | | | Two other types of genetic hair loss in men not |
| Class III - | | | | often considered by doctors, "Diffuse Patterned |
| The third class, also known as the "Vertex" class, | | | | Alopecia" and "Diffuse Unpatterned Alopecia," pose |
| represents early hair loss in the crown of the | | | | a significant challenge both in diagnosis and in |
| head (vertex). | | | | patient management. Understanding these |
| Class IV - | | | | conditions is crucial to the evaluation of hair loss in |
| The fourth class in the Norwood system is | | | | both men and women, particularly those that are |
| characterized by further frontal hair loss and | | | | young when the diagnoses may be easily missed, |
| enlargement of vertex. However, there is still a | | | | as they may indicate that a patient is not a |
| solid band of hair across top separating front and | | | | candidate for surgery. |