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  5. How To Measure Your Hair Loss With The Norwood Scale?

Are you worried about your receding hairline? You may be facing an early hair loss condition.

Hair loss is a common problem that begins for most men and women in their mid-thirties. However, addressing the issue early on can prevent further damage.

In this article, know about the early signs that indicate a hair loss condition. Compare your hairline with the different stages described in the Norwood Scale to know the right time to consult your Ayurvedic doctor.

How To Identify Early Hair Loss?

Shedding [1] around 50 to 100 hair-strands a day is part of the normal hair growth cycle. But if you are experiencing more hair fall than that, you might be facing a hair loss condition called Androgenic Alopecia. Both men and women may begin to notice the first signs of hair loss as early as in their late twenties or mid-thirties.

However, there is nothing to stress about. "Hair loss in early stages is reversible. With a combination of proper internal medicines, external therapies, diet and lifestyle, one can prevent and treat premature hair fall,” says Dr. Zeel Gandhi, Chief Ayurvedic Doctor at Vedix.

So, if you happen to spot any of the below mentioned signs of early hair loss, consult your Ayurvedic doctor right away to prevent further damage.

Male Pattern Baldness (Androgenic Alopecia in Men)

male pattern baldness

The hair loss pattern for men differs from that in women. It may begin with gradual hair thinning and result in complete baldness.

1. You may notice your hair thinning at the temples.

2. Deformity of the hair structure begins at the crown area, while hair at the back and sides remains intact.

3. You may notice a receding hairline with excessive hair loss.

4. As hair follicles begin to shrink, a shorter hair growth cycle for men may be noticed. Where normally the Anagen (growth phase) lasts around 4 to 7 years, early balding can reduce this time span. Your hair may quickly transition into the Catagen phase. Here hair growth slows down and soon falls off with the onset of the final Telogen phase.

Female Pattern Baldness (Androgenic Alopecia in Women)

woman closeup of hair loss

Hair loss in women is usually characterized by overall thinning of hair, and is not just restricted to the crown area.

1. If you are frequently changing your hairstyle to cover up a widened part on your scalp, it might be an indication of early hair loss.

2. Since women tend to experience a diffused hair loss, you might notice your ponytail thinner than before.

3. A receding hairline coupled with excessive hair loss is also a pointer. While it's common to see hair fall every time you shampoo, if you find lumps of hair in your comb, pillow or all over the place, it is time to consult your Ayurvedic doctor.

In Ayurveda, early hair loss or Androgenic Alopecia can be co-related to a similar condition referred to as Khalitya. In Khalitya, hair loss occurs as hair follicles miniaturize with the lack of proper nutrition or due to blockage of the blood supply that nourishes hair roots.

As per Ayurveda, when your Doshas are not in equilibrium, the body tends to fall into a diseased state which includes hair loss. When your Vata and Pitta Doshas are aggravated and your Kapha Dosha combines with Rakta (blood tissue) it leads to Khalitya.

The aggravated Vata-Pitta generates excess heat in your scalp and scorches the hair follicles. The Kapha Dosha along with Rakta blocks off the nutrition source, preventing hair growth.

What Is The Norwood Scale?

Hair loss patterns [2] have been researched by various scientists and several classification methods have been proposed over the years. The most popular among them is the Norwood Hamilton scale. This is used to measure the stages of Male Pattern Baldness.

First developed by an anatomist named Hamilton in 1951, the scale offered a stage-wise classification with detailed images of hair loss commonly faced by men after puberty. This classification was later revised by Dr. O’Tar Norwood in 1975 to form the Norwood Hamilton Scale.

Here, Dr. Norwood classifies male pattern baldness into 7 main stages or types.

What Does The Norwood Hamilton Scale Measure?

Male Pattern baldness as observed by Dr. Norwood, begins from the frontal area and the crown/vertex where the hair starts thinning. This thinning gradually progresses to cover the entire top of the scalp and the scalp is exposed.

The Norwood scale [3] presents in detail the step-wise recession of the hairline, which finally leads to complete baldness in men.

What Are The 7 Stages Of Hair Loss?

The seven stages mentioned in the Norwood hair loss classification system, depending on the severity of hair loss are as follows:

1. Type I - Bare minimum or negligible recession of the hairline.

2. Type II - Slightly receding hairline in the shape of symmetrical triangles in the frontal area.

3A. Type III - The hairline recedes enough to be technically termed as the initial stage of balding as per the Norwood scale. There is a noticeable recession in the frontal area which leaves the temple zone almost bare with minimum coverage.

3B. Type III Vertex - Here the hair loss happens mainly at the vertex area and less at the frontal zone.

4. Type IV - The hairline recession is much deeper, forming a clear M shape with balding at the vertex. Both these zones are bridged by a mat of thick hair that covers the top of the scalp and joins the hair at the sides.

5. Type V - There is more hair loss at the vertex and the temporal zone, while the bridge of hair connecting them becomes thinner.

6. Type VI - The two balding areas connect with barely any hair left on top to separate them.

7. Type VII - The hairline bears the shape of an U with fine hair covering the sides. This is the most advanced and final stage of hair loss.

How Does Hair Loss Look Like For Each Stage?

The Norwood scale is most referred to by doctors, due to its detailed explanation accompanied by images that represent step-wise recession of the hairline. The hair loss for each stage is illustrated below.

types of male baldness

What Are The Treatments For Hair Loss?

woman having shirodhara treatment

1. Ayurvedic Treatments

The appropriate treatment for your condition can be prescribed after the determination of your Prakriti or your unique body constitution. The age old texts of Ayurveda mention various time-tested therapies to cure hair loss.

From unique herbal concoctions that balance your Doshas to ancient cleansing procedures that nourish and rejuvenate your body systems, Ayurvedic treatment for hair loss usually involves Poshana (nutrition), Shirolepas (hair pack), Shiro Abhyanga (head massage), Shiro Dhara (pouring of herbal liquid), Nasya (administration of herbal liquids through the nasal cavity) and Rasayana therapy.

A. Poshana

Poshana or nutrition [4] plays a key role in fostering your hair follicle's health. Since hair is believed to be a byproduct of Asthi dhatu (bone tissue), diet that improves bone health is usually prescribed.

This includes proteins (fish, eggs, legumes, soya beans), vegetables and fruits that are rich in Vitamin A, B, C, D, E and K. Carotene and minerals such as Zinc and Iron supply the required nutrition to your hair follicles.

Certain Ayurvedic superfoods such as Triphala, Brahmi, Amla, Fenugreek (Methi), Curry leaves, Almonds and other nuts may be recommended by your doctor. Moringa and Ghee are also known to promote hair growth.

B. Shirolepa

A Shirolepa is an Ayurvedic hair pack made from one or more herbal infusions in powdered form. It is applied on the affected areas or on the entire scalp to awaken dormant hair follicles that have miniaturized due to the harsh effects of the aggravated Pitta dosha. After application, the pack is kept for 30 minutes and then washed off with water.

Ancient Ayurvedic herbs are used in Shirolepa to cure various forms of Shiro Roga (scalp diseases) which includes Khalitya or baldness. Frequently used among these to cure hair loss are Gunja beeja (rosary pea), Ashwagandha, Jatamasi, Brahmi, Bhringraj and Amla.

C. Shiro Dhara

Here, a powerful mix of Ayurvedic oils are gently poured on the forehead and allowed to flow down to the head and neck to relieve scalp related issues. This process is often followed by an intense Ayurvedic head massage or Shiro Abhyanga.

D. Shiro Abhyanga

An Ayurvedic head massage using special herbal oils is a complete treatment for various scalp related problems. A proper Shiro Abhyanga is capable of increasing blood circulation to the hair follicles and balancing the Vata, Pitta and Kapha doshas to promote hair regrowth.

It also cures other scalp related issues such as Shiro Rukshata or dry scalp that lead to dandruff, and Shiro Kandu or irritation in the scalp.

The process involves massaging your scalp for 15 minutes with specially formulated Ayurvedic herbal oils made from Bhringaraj, Brahmi, Japa (Hibiscus), Onion, Methi, Amla and various other herbs with Keshya (hair) properties.

E. Nasya

Here, Ghee or Ayurvedic oils are administered through the nasal cavity to cure various Dosha-related body problems that include Khalitya or hair loss. Nasya can only be performed by an Ayurvedic professional in an Ayurvedic centre.

F. Rasayana Therapy

The Rasayana Chikitsa [5] follows the Panchakarma procedure or a combination of five different procedures for treating hair loss. This is a 21-day holistic healing process. It includes oral medication made from unique Ayurvedic herbs, a strict Rasayana diet, and other medicated cleansing procedures termed as the Panchakarma.

Rasayana Therapy deals with the core of the problem to provide nutrition to the hair follicles and prevent premature shedding. Ayurvedic herbs used in Rasayana for promoting hair growth are Amlaki, Brahmi, Guduchi, and Ashwagandha.

2. Other Medical Treatments

woman receiving injection on scalp

A. Finasteride

Finasteride is often prescribed to treat Male Pattern Baldness. This FDA approved drug prevents the rise of Androgen hormone, which causes hair loss. By lowering the Androgen or DHT levels on the scalp, Finasteride can prevent miniaturizing of the hair follicles.

This promotes hair growth and prevents an early transition of your hair into the Telogen phase. The effects of the medicine begin to show after 6 months of continuous usage and may fade once you discontinue it.

Side effect: Though commonly recommended, using Finasteride over a long period may result in sexual dysfunction and male breasts in men.

B. Minoxidil

This is another FDA approved medication used in the treatment of MPB. It is usually available as a topical solution in different concentrations. While a Minoxidil 2% is likely to show desired results for early hair loss, a 5% or 10% may be prescribed for more advanced stages of baldness.

Minoxidil falls under the category of Vasodilator medication which helps to dilate blood vessels allowing more oxygen and blood to reach the hair follicles. You may notice a sudden increase of hair loss in the first 4 to 8 weeks of using Minoxidil, but this is normal.

The sudden increase in the supply of nutrition to the hair follicles makes hair in Telogen phase shed. These strands are then replaced by healthy hair in their Anagen phase.

Side effect: The commonly faced side effects are scalp dryness and itchiness in the affected areas. It is recommended that you wash your face after applying Minoxidil to prevent the growth of unwanted hair.

C. Platelet Rich Plasma Therapy

The PRP Therapy is a relatively new treatment recommended to treat both Male and Female Pattern Baldness. Researchers believe that your platelets have healing properties as they are the first to respond in case of an injury to the body.

Hence, Platelet rich Plasma Protein is derived by putting a tiny sample of your blood in a centrifuge. Once the red blood cells are removed from the blood, these platelets are injected to the balding areas on your scalp to rejuvenate your dormant hair follicles.

Though not much research has been done on the results of PRP, there is a good number of positive reviews from patients.

D. Hair Transplant

It is usually recommended as a last resort to correct advanced stages of baldness. In this procedure, hair follicles from the donor area (back or sides of the head) are removed and placed at the recipient site.

Recent advanced techniques of hair transplant claim to be almost painless with mild sensitivity in the recipient area for a couple of weeks. The donor zone heals very quickly and you can resume normal work life within 2 to 3 days of the procedure.

However, only people with a good donor zone are eligible for a hair transplant. The procedure is at times combined with PRP treatment to boost the health of the transplanted hair follicles. You should be able to see desired results within 6 to 8 months of the procedure.

People facing advanced hair loss can opt to have a Synthetic Hair Transplant. Synthetic hair looks like natural hair and is made from artificial fibre that is safe to be transplanted on to the scalp.

When Should You See A Doctor About Hair Loss?

It is imperative to consult your Ayurvedic doctor as soon as you notice excessive hair fall. An early detection of your hair issue can help to resolve the problem faster. Hair fall after pregnancy or certain medications usually rectifies on its own with the growth of new hair in place of the old ones. With age, a Norwood Scale Type 2 hairline is common.

However, if you have reached Stage 3 of hair loss, or find your hair growth cycle getting longer than usual, we suggest you seek help. "Hair loss in early stages is reversible. With a combination of proper internal medicines, external therapies, diet and lifestyle, one can prevent and treat premature hair fall," says Dr. Zeel.

The Last Word

It is advisable to seek medical help as soon as you notice the first signs of hair loss. Balding begins from the onset of Type III stage as per the Norwood Scale. Finding the underlying cause of your hair loss is of utmost importance in order to prevent further damage. Ayurveda’s holistic approach to healing not only prevents temporary hair loss but prevents the recurrence of the problem.

Know Your Dosha Now