Are you worried about your hairline and think that you are at Norwood stage 2 (NW2)? Maybe a doctor has even formally diagnosed you with male pattern baldness NW stage 2.
In this article, you will learn everything you need to know about the Norwood stages of hair loss and exactly what you will be able to do at stage 2 to avoid any further recession.
What is the Norwood Hair Loss Scale?
The degree to which your hair loss has advanced has a significant impact on the treatment methods you should choose. This is why it is important to have a clear understanding of the various stages of hair loss. This will allow you to place yourself correctly on the scale, and choose the treatment best tailored to your needs.
First things first, what is the Norwood scale for hair loss?
Developed in the 1950s and later revised in the 1970s, the Norwood hair loss scale is a classification method that determines the extent of a man’s pattern hair loss (1).
Within the scale, there are seven major classifications and four minor variants.
The Seven Norwood Classifications
When utilized by a professional, you can obtain a classification that determines at what stage in the hair loss process you currently are. In most cases, you will also be able to tell where you are on the scale simply by the description below, and the help of the illustration above.
- I – Little to no hairline recession.
- II – Triangular, typically symmetrical, areas of frontotemporal hairline recession.
- III – Deep, symmetrical recession at the temples that are bare or very minimally covered by hair.
- IV – Worsening frontotemporal recession, with little to no hair on the vertex.
- V – The hair loss seen in the frontotemporal and vertex regions are still separate, but are becoming less distinct from each other.
- VI – The frontotemporal and vertex hair loss regions are combined, with only sparse patches of hair remaining between the two.
- VII – Only a horseshoe pattern of hair remains, wrapping around the back and sides of the head. The rest of the head is bald.
NW 2 Hairline – Natural Recession or Precursor to Balding?
There is a bit of debate surrounding hair loss classifications. This is true even when discussing a descriptive scale such as the Norwood scale (1).
So, is a NW2 hairline a natural recession or is it always indicative of future balding? Before we answer this, let us first define a natural recession.
As you age, the hairline naturally recedes. This is known as a mature hairline, and in no way indicates future hair loss (2). Instead, a mature hairline simply gets rid of the more rounded hairline features seen in boys and provides a more angular shape. It is a natural process that accompanies maturation in teenage boys, just like a hairy chest and deep voice.
But when does a hairline go from mature to receding, and how can you tell? The key is how far the temples have recessed, and just how high up the new hairline is.
You can learn more about how to distinguish between a mature and recessed hairline here.
So, back to NW2 – is it natural or a sign of progressive loss? The answer is that it is the first sign of pattern hair loss. If you are a NW2, this suggests that without treatment, you will very likely progress to a Norwood 3 and eventually beyond that.
Cause of NW2 Hairline
While there are plenty of hair loss causes – including stress, illness, and medications – Norwood describes the most common cause, male-pattern baldness (3).
Medically referred to as Androgenetic Alopecia (AGA), male-pattern baldness is a chronic form of hair loss. Most commonly seen in men, pattern hair loss can also occur in women, though the pattern is completely different (4).
To best treat hair loss, you need to understand exactly what leads to it in the first place.
In simplest terms, male-pattern baldness can be attributed to sensitivity to DHT. This is a naturally-occurring male hormone (androgen) and a byproduct of testosterone (5).
In all individuals, DHT travels to the scalp and interacts with the androgen receptors. These are at the base of the hair follicles throughout the scalp.
In individuals with DHT sensitivity, however, DHT’s activation of these receptors leads to problems. Through a biochemical reaction that scientists do not yet understand, the end result is hair follicle miniaturization.
In the end, the follicle is too damaged to do its job and can no longer grow hair.
In individuals with pattern hair loss, DHT is most abundant in the temporofrontal region of the scalp. This is why hair loss typically starts in these regions, and why the Norwood scale is so effective at diagnosing male-pattern loss.
How to Treat a NW2 Hairline
The good news is if you are classified at the number 2 stage, then your hair loss has not progressed to an irreversible point. Instead, you are in a good position for stopping the hair loss in its tracks and growing back some healthy hair.
There are two key elements of doing so, and they involve stimulating the hair follicles and removing DHT from your scalp.
Stimulate the Hair Follicles
Depending on how long you have been in stage 2, you may be able to lower your hairline back to its original position. This will depend upon the extent of the hair loss, as well as genetic factors.
To get started, you can use microneedling and scalp massage – two natural methods for stimulating the growth of new hair.
As you can imagine, blood flow is crucial to the health of the hair follicle. Without proper flow, the follicles do not get enough of the vital nutrients they need.
Both microneedling and scalp massage work to increase blood flow to the hair follicles. They do this in different ways.
Microneedling works by stimulating the scalp with tiny needles. These needles create tiny perforations which induce healing and promote the growth of healthy new skin and hair (6).
Scalp massage, on the other hand, is an entirely external process and involves the massaging of scalp tissue. Scientists do not understand exactly how scalp massage promotes hair growth. A recent study, however, found that the manual stimulation of the scalp with the massage can actually alter the expression of certain genes that regulate hair growth (7).
To keep things simple, you can perform 5 minutes per day of scalp massages all over the head to loosen the scalp and reduce fibrosis and calcification.
Remove DHT from Your Scalp
If DHT is the main cause of male-pattern hair loss, then removing DHT from your scalp is certainly a step in the right direction.
Over time, a plaque builds up on your scalp. This contains oil, dirt, dead skin, hair products, and maybe even DHT. When this plaque remains on your scalp, it continues to cause harm to the follicles.
Fortunately, removing this epidermal plaque is quite simple.
What You Will Need:
- Himalayan or Celtic sea salt (½ TBSP)
- Powdered activated charcoal (1 TSP)
- Lemon juice (one whole)
Combine the salt, charcoal, and lemon juice. Mix in the container of your choice.
Apply the mixture to the area of your scalp you would like to target most (in this case, the temples and forehead). Massage gently, and then allow to sit for five to 10 minutes.
Rinse thoroughly with lukewarm water and gently finish peeling the rest of the mixture from your scalp.
You may repeat this process as many times as you feel is necessary, though no more than two times per week.
Get a Hair Transplant
While this is not something commonly recommended as a first-line treatment, hair transplants are a treatment that many men facing hair loss choose to pursue.
If you are considering a hair transplant in order to treat your NW2 hairline, here are a few things to consider:
- A transplant is not a cure. While a transplant can temporarily cover the baldness caused by androgenetic alopecia, you can continue to lose hair if you do not treat the root of the problem.
- There are some serious side effects. As a minor procedure, many people forget that hair transplants can come with their own set of side effects. If the surgeon performing the procedure is not properly trained, some of these can be harmful to your long-term health.
- Not everyone is a good candidate. There are a few factors that doctors consider, including age, type of hair loss, and amount of hair loss present (8). Hair transplants are an example of a medical intervention where earlier is not generally better. On the contrary, the longer you wait (after you have stabilized your hair loss), the more likely the transplant will provide a permanent solution.
It is true that hair transplants can be an effective method of lowering the hairline and boosting your self-confidence. Just keep in mind that transplants are not a cure and that if you don’t use other treatment methods, you are very likely to get poor results in the long term.
A Norwood 2 hairline signals the onset of male pattern baldness. As such, it can be an emotionally unsettling experience to one day realize that you are a Norwood 2. On the other hand, if you are reading this while you are still a Norwood 2, the good news is that you are in an excellent position to treat your hair loss.
Because the hair loss has not progressed to more advanced stages, there is a very good possibility you will be able to stabilize it, and now allow it to get worse. After you have stabilized it for some years, and perhaps even regrown back some hair, you can then consider a hair transplant to restore your hairline back to a Norwood 1.