Hair loss is a big worry to many people, both male and female. If you have a worrying amount of hair in the basin after shampooing, you may think you are on the way to baldness. But this is not usually the case. The 50–100 hairs that everyone loses each day often become tangled with the rest of the hair, but are washed out when we shampoo. So we see what seems like a lot of hair in the basin after shampooing, but in reality these hairs have been shed earlier.

The word “alopecia” is the medical term for hair loss. Alopecia does not refer to one specific hair loss disease — any form of hair loss is an alopecia.

Hair loss can be caused by any number of conditions, reflected in a specific diagnosis. Some diagnoses have alopecia in their title, such as alopecia areata or scarring alopecia, but many do not, such as telogen effluvium.

Alopecia can be caused by many factors from genetics to the environment. While androgenetic alopecia (male or female pattern baldness, AGA for short) is by far the most common form of hair loss, dermatologists also see many people with other forms of alopecia. Several hundred diseases have hair loss as a primary symptom.


There is a lot of jargon around regarding hair loss and one of the descriptions people use to describe their hair loss if referring to the Norwood scale of hair loss which is often abbreviated to NW1 etc. The correct terms for normal hair loss (and hair loss in men is pretty normal) is androgenic alopecia.

The scale goes from Norwood 1 to Norwood 7. Norwood 7 is what we are all trying to avoid and involves a total hair loss from the top of the head with only the hair around the sides remaining.


NW1 – NO HAIR LOSSThis is where hair loss has just begun and is not really noticeable – No surgery.


NW2 – RECEDING HAIRLINEThis is just where there is a very small amount of hair receding at the hair line or at the temples.


NW3 – GENERALIZED FRONTAL THINNINGThis is probably the first stage where you would say to yourself that you were definitely starting to lose your hair with a much more pronounced receding at the temples.


NW3 VERTEXThis is when the hair loss is from the crown of the head and with only very limited receding from the temples or hairline.


NW4 – FRONTAL AREA AND CROWN BALDINGThis is when you get a bald patch on your crown plus your hairline at the front has receded. The front hair line to the bald patch however are still separated by a reasonable covering of hair. Eventually though these two bald areas grow to meet each other, which is what we are trying to avoid.


NW5 – TOP OF SCALP AND CROWN BALDINGThis is a worsening of NW4 with the reasonably dense hair separating the bald patch from the receding temples becoming less, resulting in a much larger bald area and much greater recession at the temples. At this stage the amount of scalp showing is significant and the persons hair is noticeably thin.


NW6 – EXTENSIVE HAIR LOSSThe bridge of hair that separated the receding temples from the bald crown has now receded with only sparse hairs remaining. In places the bald patch has met the receding temples with much less hair remaining. Often people still have hair at the very front of their head for the rest of their lives (Quentin Wilson style).


NW7 – SEVERE HAIR LOSSThis is as far as the hair loss will go. There is now no hair to speak of on the top of the head and only the hair around the sides remaining in a sort of U shape around the head. Best to shave your head or get a No.0 haircut at this stage.


There are many causes of hair loss, but the main 4 that account for almost all types are

  • Androgenetic Alopecia – known as Male pattern Baldness (MPB) – 92% of cases
  • Telogen Effluvium – upto 3%
  • Alopecia Areata – 1% to 2%
  • Scaring Alopecia – 1% to 2%

Male Pattern Baldness (MPB)

Androgenetic alopecia or common male pattern baldness (MPB) accounts for more than 95% of hair loss in men. By the age of thirty-five two-thirds of men will experience some degree of appreciable hair loss, and by the age of fifty approximately 85% of men have significantly thinning hair. Approximately twenty five percent of men who suffer with male pattern baldness begin the painful process before they reach the age of twenty-one.

Contrary to societal belief, most men who suffer from male pattern baldness are extremely unhappy with their situation and would do anything to change it. Hair loss affects every aspect of the hair loss sufferer’s life. It affects interpersonal relationships as well as the professional lives of those suffering. It is not uncommon for men to change their career paths because of their hair loss.

MPB , is caused by the effect of the male hormones, called androgens, on genetically predisposed hair follicles (passed down the family tree). For those who are prone to hair loss, within these genetically programmed hair follicles the male hormone ‘testosterone’ is converted into the androgen ‘Dihydrotestosterone’, or ‘DHT’, by an enzyme called 5-alpha reductase. It is the effect of this DHT that inhibits the growth of new hair cells, which in turn leads to male hair loss and in many cases, eventual baldness.

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