Dr.'s recognized expertise Smarrito Decision support

Baldness: the 7 stages of the Norwood-Hamilton scale and hair transplantation

Assess your stage of baldness (androgenetic alopecia) on the Norwood-Hamilton scale and discover the appropriate strategy: hair transplantation (MCE, FUE Saphir) or other treatment. Select a stage for the indication and recommended technique.

Hair transplant without shaving — MCE © FUE Single Sapphire Natural effect Follow-up by FMH surgeon

The 7 stages of baldness: Click on your stage of alopecia

Hair care Balding scalp Area disappeared (outline) Selected stage

Top view of the scalp, forehead upwards (reference point ▲).

Complementary and alternative treatments to transplantation

For established alopecia (stages III and IV), transplantation is the gold standard solution : the donor area is resistant and intact, and the surface area is well-defined. The treatments below preserve native hair and complement transplantation; they constitute the primary treatment in early stages (I-II) or when surgery is not indicated.

1. Slow the fall

Medical treatments

  • Oral medical treatment inhibiting DHT (prescription required)
  • Topical Minoxidil 5%
  • Adjuvant topical treatment of the scalp
2. Densify

Regenerative medicine

  • Autologous exosomes (derived from the patient)
  • PRP — platelet-rich plasma
  • Mesotherapy / scalp microneedling
3. Stimulate

Biostimulation

  • Scalp biostimulation lasers (LLLT)
  • Photobiomodulation — maintenance treatments
  • Thulium laser for scalp stimulation
4. Camouflage

Aesthetic solutions

  • Scalp micropigmentation (SMP)
  • Useful as a supplement when the donor area is limited
Prior - Confirm the androgenetic origin and rule out differential diagnoses (telogen effluvium, alopecia areata, scarring alopecia) before making any decision. Only Dr. Smarrito receives the patient for consultation, analyzes the donor area and establishes the strategy: from simple medical treatment to an extensive transplant.

References

  • • Hamilton-Norwood classification (Norwood O., 1975) — grading reference
  • • Systematic review of exosome treatment in hair restoration — PubMed PMID: 37381168

F.A.Q

What is the Norwood-Hamilton scale?

This is the reference classification for male pattern baldness (androgenetic alopecia). It describes 7 stages, from stage I (intact hair) to stage VII (advanced baldness), by observing the frontal line, temples and vertex.

At what stage is a hair transplant indicated?

From stages III and IV onwards: the area to be grafted is moderate to large and the donor area remains intact. This is the ideal indication for a MCE (no-shave) or Sapphire FUE graft.

What to do at the beginner stage (I-II)?

Maintenance care: regenerative medicine (autologous exosomes, PRP) and photobiomodulation with thulium laser, to preserve hair stock.

Dr Stéphane Smarrito · FMH Cosmetic Surgery · Quai Perdonnet 3, 1800 Vevey · Tel. 021 922 24 62 Decision aid — does not replace consultation.
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