When I was a teenager, my mother reassured me that I wouldn’t go bald in my twenties like my father had. “Look,” she said, pushing back her hair from her forehead, “You’ve got my hairline, not your dad’s.” Within ten years her argument was revealed to be magnificently wrong. My hairline began its slow march north, a clear sign that I’d inherited male-pattern hair loss from one of my parents, if not both of them. As the years went by I persuaded myself that ever-shorter haircuts made me look better than I used to. But deep down it felt unfair, a genetic quirk I didn’t deserve. I’d wince as the barber held up the mirror behind me, revealing an ever-expanding bald patch.
I pretended not to be bothered, and that pretence continues today, in my forties. But while stoically accepting hair loss as my destiny, I don’t like it. I’ve found myself wearing hats and growing a beard, attempts at misdirection that fool nobody, least of all me.
Androgenetic alopecia is the medical term for my inherited form of hair loss. While it affects both men and women, marketing by hairloss treatment companies mostly targets male anxieties. The industry is estimated to be worth at least £1.2 billion a year worldwide.
According to the UK’s National Institute for Health and Care Excellence (NICE), male-pattern hair loss affects 30 per cent of men under 30, increasing to around 80 per cent of men over 70. Its causes are well-established, if poorly understood by those of us who have it. The hormone dihydrotestosterone (DHT) is synthesised from testosterone by an enzyme, 5-alpha-reductase, that's found at the base of the hair follicle. This sets off a process of miniaturisation in hormonally sensitive areas such as the forehead and crown. The follicles shrink and, as the American Hair Loss Association puts it, they stop producing “cosmetically acceptable hair”.
The first consequence of this is progressive baldness. The second, and arguably more important, consequence is the psychological effect it has on many men. A 2005 study of men with hair loss in Germany, France, Italy, Spain and the UK found that 43 per cent were concerned about its effect on personal attractiveness, 22 per cent worried about its impact on their social life, and 21 per cent linked it with feelings of depression.
“I’d say that the most desperate emails, the people who sound like they’re at their absolute lowest ebb, tend to be from men,” says Amy Johnson at Alopecia UK, a charity that offers support and advice to men and women with all types of alopecia. “When people say it’s much harder for women, and for men it’s all right, I say actually, no, that’s not what I find.”
An internet search returns a disorienting array of options that promise to alleviate the misery of the balding man: herbal remedies, surgeries, hair pieces, shampoos and nanofibre sprays that “colour in” bald patches. Some of them work, in that the hair loss might be less apparent, but what works for one person might pan out disastrously for another.
Here are some of the options available to balding men.
WIGS AND HAIRPIECES
Jay Patel, the co-founder of wig company MH2Go, sits in his office in central London, fiddling with a pen as he recounts his tale of hair loss. “About four or five years ago I tried to commit suicide,” he says, adding that his state of mind was worsened by body dysmorphia. “I was in hospital for three weeks, and I got a lot of support. After that I told everyone that I wore a wig, and the whole burden just lifted. I stopped feeling ashamed.”
Patel is a good-looking chap, and he’d look great with or without hair. But having told me about his wig, he forces a smile. He knows that I know.
“I’ve turned something that was an issue into my livelihood,” he says.
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