The Norwood scale is a metric of hair loss for Androgenic alopecia that was the original criterion of James Hamilton in the 1950s. Modified by O’Tar Norwood in the 1970s, the scale adopted the name of the latter, but is oftentimes referred to has the Hamilton-Norwood scale.
Although not considered a reliable measure, the Norwood scale is internationally endorsed as the standard benchmark of male pattern hair loss that dwarfs all the possibilities of hair loss patterns into 7 distinct categories.
What are the benefits of the Norwood scale?
The Norwood scale classifies patterns of hair loss into 7 categories that simplify terminology between patients and doctors and assists patients in grasping the progression of their case, provide them with an extended perspective on the situation of their receding line, and helps them fathom the proposed treatments for their category.
Although the causes of androgenic alopecia are mutual among all hair loss patients, since the condition is fueled by genetics, the way androgenic alopecia presents itself varies between the afflicted patients.
The 7 classes of hair loss on the Norwood scale
CLASS I – CLASS III (Norwood scale 1, 2, 3)
The first three classifications of hair loss portray a gradation of increasing advancement of a receding hairline in the conventional M pattern. Class I has a minimal receding pattern whereas class three has the most progression of retreating hairline.
CLASS IIA – CLASS IIIA (Norwood scale 1A, 2A, 3A)
Class two and three of the subcategory A are distinct in terms that the hairline does not retreat in the classic M shaped pattern, but rather in a more uniform structure creating a very subtle M shape.
CLASS III vertex
Class III vortex is the first stage of hair loss that presents a receding hairline of stage III with the beginning of a hair loss on the vertex.
CLASS IV – CLASS V (Norwood scale 4, 5)
Classes IV and V exhibit further miniaturization of hair follicles that results in a bigger diameter of hair loss around the vortex and further recession of the hairline with a deteriorating M structure.
CLASS IV A – CLASS V A (Norwood 4A, 5A)
Hair loss that belongs to categories 4 and 5 of subgroup A is attributed by a receding hairline that moves backward collectively with an unaffected vortex and a U shaped hairline. The two categories are similar, however, class V A is a more advanced parallel of class IV A.
CLASS VI-VII (Norwood 6, 7)
Classes VI and VII are characterized by advanced hair loss and a hairline that recedes beyond the crown, with class VI attaining residual circular outline of the hair.
How can androgenic alopecia be reversed?
Once hair follicles miniaturize, the transformation is perpetual and cannot be reversed naturally. Hair transplants reverse the bald look not through reviving the grafts but replacing them.
Typically in androgenic alopecia, as is Indicated by the Norwood scale; the propensity for hair loss diminishes among hair follicles as the distance between their location and the hairline increases.
Resistance to hereditary hair loss is a genetically predisposed trait that cannot be altered physically. Therefore when the units are transplanted from their initial site to regions of hair loss, the grafts continue to prosper and flourish.
How are follicular units transplanted?
There are initially two rudiments techniques for extracting follicular units: the FUE and the FUT.
- The follicular unit extraction (FUE) technique is the most recent of the two on the hair transplant innovation timeline.
- To remove follicular units, FUE utilizes an incision punch that is 0.8 mm in thickness to isolate the hair follicle from the remaining scalp.
- A tweezer is then used to extract the graft.
- The harvested grafts are kept in Hypothermosol solution to preserve their viability.
- Channels are created on the recipient site via small edged blades.
- Follicular units are individually placed in the open channels.
- Follicular unit transplants cut a linear-shaped strip of skin from the scalp.
- The wound is then stitched.
- The strip of skin is dissected under a microscope to obtain individual grafts.
- Grafts are preserved in Hypothermosol solution
- Channels are created on the recipient site via sharp-edged blades.
- Hair follicles are inserted in the channels.
Disadvantages of FUT
- The extraction technique causes nerve damage in the area that could either be temporary or permanent.
- Wound heals into a visible scar that interferes with the patient’s choice of styles.
Does the extracted hair grow back in hair transplants?
The extracted follicular units do not regenerate in the vacant location once the original hair follicles are transplanted to a different site.
Therefore, in order not to literally reverse the pattern of your baldness, patients need to have a sufficient supply of donor hair; that will ideally cover the balding scalp while simultaneously not affecting the appearance of the donor site.
Typically, the lower the classification of hair loss on the Norwood scale is, the higher the chances of receiving a better makeover.
What can I do to increase the density of my hair growth after hair transplants?
Here’s an unknown fact, only 70% of the transplanted follicular units are projected to survive. The cause? When translocating the follicular units, their primary source of blood and by extension nutrition is cut. It takes up to four days for the hair follicles to reconnect to a direct blood supply. The adverse climes of limited oxygen can be destructive to an estimate of 30% of the transplanted follicular units.
If you barely met the requirements for the procedure, and can’t spare to lose 30% of your transplanted follicles, you can opt for the OxyCure therapy that preserves up to 99% of the grafts by boosting the cells with sufficient oxygen until their eventual revascularization.
Contact the Vera Clinic
Contact the Vera Clinic for more information.