How do docs classify MPB on the Norwood scale?

[mahhong]

There has been something that has confused me a little bit for a while that I thought would be great to get an answer for.

 

Quite often I see patients on this forum who have had an HT with their doc, who has described their hairloss pattern as, let's say for example, NW3. But when I look at the pictures even though the general "pattern" may be an NW3, it's very clear that they have miniaturization in, for example, an NWV or VI pattern.

 

This has always left me a bit confused since I always presumed the "pattern" would be classified by the extent of observable miniaturization. So, if there was any significant miniaturization that area would be classed as also experiencing MPB.

 

I hope I make sense. I was just curious since I see it a fair bit these days, when a patient is described as say a NW3 but it's very clear in their transplant photos that there is still miniaturization in the crown and vertex, but not as much as in the NW3 regions. I always assumed that if an area was experiencing miniaturization it was a fairly safe bet that area would one day also be gone.

[TC17]

For a number of reasons I put no stock in the Norwood classification system. I would find the ratio of bald or balding area to donor hair far more valuable.

[NEWHAIRPLEASE]

Dr Konior told me Norwood classification is SUPPOSED to be based on where you are going, not where you are at the current moment!

[mahhong]

Well that's what I always thought. Genetically your balding is fixed the day you're conceived and so, to that extent, you can't really be "moving" through the NW system. If you're an NW6 genetically, then that's what you are. You might appear to be moving through from NW1 to 2 etc, but ultimately there is only one destination and only artificial means (medication, transplantation etc.) can slow that down.

 

To that extent, in my head the logic would be that your NW classification has to be the extent of your miniaturization. so if you have only moderate thinning in the crown, for example, surely from a NW classification that has to be taken into account as a higher NW category?

[RCWest]

I believe you can go to three different doctors and get three different answers as to what you are on the Norwood scale. Some doctors classify as to what they believe you will end up being in the end and some classify as to what you currently are. Even just having light coverage in one area will have some docs putting you lower in the scale.