Authored by: Dr. Juan Chavez, MD and Dr. Lucia Mireles-Chavez, MD
Types of male pattern baldness are defined by predictable patterns of hair loss that doctors classify using the Hamilton–Norwood scale. In simple terms, male pattern baldness (androgenetic alopecia) usually starts with a receding hairline, a bald patch at the crown, or diffuse thinning across the top, then progresses through seven recognizable stages. Knowing which type and stage someone is in is the key to choosing the right medical treatment and timing it before more hair is permanently lost.
Most men with male pattern hair loss follow one of two major patterns: frontal hairline recession that forms an "M" shape, or a bald spot on the crown that gradually expands. As hair follicles miniaturize under the influence of male sex hormones, hair density drops, individual hairs become finer, and bald areas slowly connect. Identifying the pattern early allows a dermatologist to slow further hair loss, protect remaining hair, and plan options like medication, platelet rich plasma, or hair transplantation if needed.
Male pattern baldness, also called androgenetic or androgenic alopecia, is a type of hair loss driven by genetics and hormone sensitivity that follows consistent, recognizable patterns on the scalp.
Patterns matter because they distinguish common baldness from other causes such as alopecia areata or telogen effluvium. In patterned alopecia, hair follicles in certain regions are more sensitive to dihydrotestosterone. Over time they produce shorter, thinner hairs, leading to noticeable hair loss along the frontal area, vertex, or both. Recognizing the pattern and stage helps a dermatologist predict progression, estimate how much hair remaining is stable, and match treatment intensity to the current and likely future degree of loss.
The Hamilton Norwood scale, sometimes called the Norwood Hamilton scale, is the most widely used classification system for male pattern baldness and describes seven stages of pattern hair loss.
In Type I, the adolescent hairline is essentially intact, sitting well above the upper brow crease and showing only a very slight hairline recession, if any. Hair density across the entire scalp is normal, with no true bald spots, so this is often described as the earliest stage.
Some young men in this stage worry they are starting to lose hair because of minor frontal changes or styling techniques that expose more scalp. A dermatologist will usually reassure them that this is not yet male baldness, but they may still take a careful medical history and ask about family history of pattern baldness to assess future risk.
By Type II, there is clear frontal hairline recession at the temples, often forming an "M" shaped male pattern. This is still a relatively mild type of hair loss, but the receding hairline is visible in photos.
Type III is the first true stage of male alopecia on the scale. There is deep symmetrical recession at the temples, sometimes reaching close to or behind the upper brow crease. In many men, this stage produces noticeable hair loss to others, prompting office visits for early medical treatment to slow further hair loss.
Type III Vertex keeps a moderately dense hairline but adds a bald patch on the crown, also called the vertex. This circular or oval area of thinning hair can be small or moderately sized.
Here, the person may still have reasonably thick frontal hair, yet a clear bald spot is visible on the top of the head in mirrors or photos taken from behind. This pattern shows how hair loss in men can start mainly at the crown rather than from the front.
In Type IV, both the frontal bald area and the crown bald spot enlarge. Between them, a thin band of remaining hair crosses the mid-scalp, separating the two bald areas.
By Type V, that separating band contains only a narrow band of hair, often sparse hair that appears weaker than surrounding areas. The frontal area and crown are larger and closer together, indicating significant hair loss that is harder to fully reverse.
Type VI represents an advanced stage where the frontal and crown bald areas merge, leaving a thin band of remaining hair that can no longer fully separate them. The classic horseshoe shape begins to appear as hair remaining is mainly around the sides.
Type VII is the most advanced stage of male hair loss. There is complete hair loss across the entire top of the scalp, with only a wreath of hair around the sides and back. At this most advanced stage, only a wreath or very thin band of hair may serve as donor hair for a hair transplant, and medical treatment mainly focuses on preserving what remains rather than restoring complete density.
Within the Hamilton Norwood scale, several major patterns show how androgenetic alopecia typically affects men across the frontal and vertex regions.
The most recognizable pattern baldness sign is frontal hairline recession at the temples, shaping the hairline into an "M" or "V." Men may first notice this receding hairline when styling hair or seeing photos that reveal more scalp near the temples.
In these types of male pattern baldness, the central frontal hairline can remain relatively strong for years. The temples, but, continue a slow hairline recession backward, sometimes producing a deep "M" contour while the midline stays forward. Over time, diffuse thinning can spread into the frontal hairline, flattening it and leading to more severe hair loss.
Another major pattern is hair loss that begins at the crown, creating a small bald patch that gradually enlarges. Early on, this bald spot may show a ring of thin band hair, giving a "halo" appearance around the center of the vertex.
With progression, the bald patch widens and the hair remaining around it becomes sparser. This crown pattern often corresponds to Type III Vertex and Type IV on the Norwood scale, and can eventually connect with frontal loss to leave only a wreath of hair.
Some types of male pattern hair loss show diffuse thinning rather than sharp bald spots. The person does not see a single bald area but instead notices that hair density is lower across the entire top.
In diffuse thinning, individual hairs become finer and shorter, and more scalp shows through, especially under bright light. This pattern can be mistaken for telogen effluvium, another type of hair loss, so clinicians look carefully at the distribution and family history, and may check for any bald spots or recession to confirm patterned alopecia.
A less common but still recognized pattern involves very deep temporal recession with relatively stable hair in the mid-scalp. The temples form steep recessions, while a strong central strip of moderately dense hair runs from frontal to crown.
This pattern fits within the two major patterns on the Hamilton Norwood scale but has a distinctive look. Styling techniques may camouflage the deep temporal loss by pulling hair forward from the preserved mid-scalp, but the underlying male pattern is still present and often progressive.
Not everyone fits neatly into one Norwood stage, and some men show mixed or less typical patterns of male alopecia that still reflect androgenetic mechanisms.
In this variation, there is diffuse thinning over the top and crown with little change to the frontal hairline. From the front, hair may look normal, but overhead lighting reveals reduced density.
This type of hair loss can overlap with telogen effluvium, especially after illness or major stress. But, if family history strongly suggests pattern baldness, and miniaturized hairs are seen on exam, clinicians often diagnose diffuse patterned alopecia and consider early medical treatment to protect remaining hair.
Some men develop an early bald spot on the crown while the frontal hairline stays almost unchanged. This pattern matches the vertex-focused stages of the Norwood Hamilton scale.
Because the person does not see the top of their head easily, family members or barbers often first notice the bald patch. When the person finally sees photos from behind, the degree of hair loss can be surprising, sometimes revealing more advanced stage than expected.
Another variation shows asymmetrical hairline recession, where one temple recedes faster than the other. Over time, both sides usually progress, but the uneven look can cause early concern.
As long as there are no patchy bald spots suggesting alopecia areata, and the pattern still follows a recognizable male pattern, this is usually considered a normal variant of androgenetic alopecia. A dermatologist still evaluates for rapid hair loss or other factors that might contribute, then stages the pattern using the standard classification system.
The specific type and stage of male baldness strongly influence which treatments will help, how much density can be regained, and what realistic goals look like.
Early stages, especially Types I to III, have many functional hair follicles that still grow hair, even if they are miniaturizing. In these stages, treatments that slow further hair loss, such as prescription medications, tend to have the greatest impact.
Men with a receding hairline or small crown bald spot usually have more remaining hair that can thicken with treatment. A dermatologist can also discuss non-surgical options like platelet rich plasma injections, which may improve hair density in selected patients when used alongside standard therapies.
In more advanced stages, such as Type VI or VII, large regions of the entire scalp top may have complete hair loss or only sparse hair. Medical therapy can still protect the wreath of remaining hair, but restoring full coverage is often not realistic.
At that point, surgical hair transplantation from stable donor hair on the sides and back becomes a key option. But, because there is only a narrow band of donor hair in the most advanced stage, surgeons must design conservative, natural hairlines rather than trying to recreate an adolescent hairline that the donor supply cannot support long term.
The main types of male pattern baldness are classified on the Hamilton–Norwood scale, which has seven stages. Patterns typically include a receding "M"-shaped hairline, a bald spot at the crown (vertex), diffuse thinning across the top, or mixed patterns where frontal and crown loss gradually connect.
The Norwood scale ranges from Type I, with minimal or no recession, to Type VII, with extensive baldness across the entire top and only a horseshoe-shaped rim of hair remaining. Intermediate types track progression from early temple recession or a small crown spot to large connected bald areas.
Earlier stages on the Norwood scale, especially Types I–III and Type III Vertex, respond best to treatment because many follicles still produce hair, even if thinner. Medications and options like platelet-rich plasma typically work better at thickening and preserving hair before large smooth bald areas develop.
Male pattern baldness can begin any time after puberty, but many men first notice changes in their 20s or 30s. By age 50, about half of men show some degree of patterned hair loss. Genetics and hormone sensitivity largely determine when visible recession or crown thinning starts.
Types of male pattern baldness are driven mainly by genetics and hormone sensitivity, so complete natural reversal is unlikely. Healthy habits may support overall hair health, but they do not reliably stop androgenetic alopecia. Evidence-based treatments and early medical evaluation offer the best chance to slow or partially reverse loss.
Types of male pattern baldness follow clear patterns that the Hamilton Norwood scale captures in seven stages, from minimal recession to near complete hair loss across the top. Understanding whether someone has an "M"-shaped hairline, a crown bald patch, diffuse thinning, or mixed features helps predict progression and guides treatment choices.
Once the pattern and stage are known, a person can work with a dermatologist or hair specialist to protect remaining hair, slow further hair loss, and, when appropriate, explore options such as platelet rich plasma or hair transplantation. Knowing the pattern is not just a label: it is a roadmap for managing male pattern hair loss over the long term.
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