How many grafts for Norwood 4?

Typical clinic estimates are 2,000 to 3,000 grafts for Norwood 4, enough for the hairline and a moderate crown. Some surgeons split this across two sessions.

Is Norwood 4 too late for finasteride?

No. Finasteride mostly preserves the hair you still have, and at stage 4 that is still most of it. Regrowth in the bare areas is unlikely, which is why stage 4 is often treated with both medication and a transplant.

What is the difference between Norwood 4 and 5?

The band of hair between the front and the crown. At stage 4 it is solid; at stage 5 it is narrow and thinning, so the two bald areas are nearly joined.

Norwood scale, stage 4

Norwood 4

Deeper frontal recession and a clear bald patch at the crown, still separated by a solid band of hair across the top.

Balding under the scale: Yes
Typical age: 30s to 40s, earlier in men with a strong family history.
Estimated grafts (first session): 2,000 to 3,000
Estimate cost for 2,000 to 3,000 grafts →
Transplant candidacy: Commonly performed. A single session usually covers the affected area.

What Norwood 4 looks like

At Norwood 4 the hairline has receded further than stage 3 and the crown has an obvious bald or very sparse patch. What defines stage 4 is the bridge: a band of reasonably dense hair still runs across the top of the scalp, separating the front from the crown.

This is the stage where hair loss becomes visible to other people from most angles, and the stage at which many men first book a consultation.

How common is Norwood 4?

A common stage for men in their 40s. Stage 4 is also the most common stage for a first hair transplant.

What people at Norwood 4 typically do next

A transplant is common and usually gives a clear result, because the donor area is still strong and the bald areas are well defined.
Medication is still recommended alongside surgery to protect the bridge of hair between the front and the crown.
Some men choose a buzz cut or scalp micropigmentation instead; stage 4 is where those options start to compete with surgery.

These are the options people at this stage commonly weigh, not a recommendation. A dermatologist or hair restoration surgeon can assess your donor area, hair calibre and the cause of your hair loss.

All Norwood stages

1 2 3 3V 4 5 6 7

Not sure which is yours? Use the stage finder.

Where Norwood 4 sits on the full chart

Compare Norwood 4 with its neighbours on the original chart: stages 1 to 7 and 3 vertex in the left and middle columns, the A variants on the right. Chart: Keministi via Wikimedia Commons, CC0 (public domain).

Norwood 4: frequently asked questions

How many grafts for Norwood 4?: Typical clinic estimates are 2,000 to 3,000 grafts for Norwood 4, enough for the hairline and a moderate crown. Some surgeons split this across two sessions.
Is Norwood 4 too late for finasteride?: No. Finasteride mostly preserves the hair you still have, and at stage 4 that is still most of it. Regrowth in the bare areas is unlikely, which is why stage 4 is often treated with both medication and a transplant.
What is the difference between Norwood 4 and 5?: The band of hair between the front and the crown. At stage 4 it is solid; at stage 5 it is narrow and thinning, so the two bald areas are nearly joined.

Sources

Stage definitions follow Norwood's 1975 classification. Graft estimates are typical clinic planning figures for a first session and vary with hair calibre, donor density and hairline design.

How Bald is an information site, not a clinic. Nothing here is medical advice and we do not sell procedures or medication. Figures are estimates with sources listed on our methodology page. Talk to a dermatologist or hair restoration surgeon before treatment.