bald!
by Jenny Bryan
Russell started to lose his hair seven years ago when he was 21. Now, having tried every spray and potion on the market, he's taking clippers to his head and shaving off his fringe of hair. Totally bald, he instantly looks 10 years younger than when he was clinging on to his last few strands. But he admits that it's been a tough journey to accept his bald state.
© Getty
'First of all there's panic, then it's denial because you refuse to accept that the way you've looked for so many years has now changed irreparably. That's when you move on to treatment and, if that doesn't work, you reach rock bottom. A part of you dies and you realise there's nowhere left to go, and that's where acceptance comes into it,' he says.
At 23, Ian is a long way from making the same bold decision as Russell. He is three months into a one year programme of laser treatment aimed at giving him back the amount of hair he had at 18.
The fuzz on the top of his head looks promising, but it may owe more to the hair restoring lotion, Regaine, that he is also using. There isn't any independent scientific evidence that pointing a laser at empty hair follicles makes them work again. But there is good data to show that 60% of men who use Regaine (also called minoxidil) do get some regrowth, especially if they start when their bald patch is small.
Originally developed for treating high blood pressure, no one knows how Regaine works. It's on sale at pharmacies and from trichologists. If Regaine is going to work, you should see some sign of a reduction in hair loss within four to six weeks and, if it does work, you'll need to keep taking it.
The same is true of Propecia (also called finasteride) which men can get on private prescription from their doctor. Designed to treat enlarged prostates, Propecia blocks the production of the male sex hormone, testosterone, which makes the prostate gland grow. Although male baldness is usually caused by over-sensitivity of the hair follicles to testosterone, rather than too much of it, reducing the amount that a man produces does seem to help about two thirds of balding men who try it. The only downside is that a few men get a reduction in their libido.
male pattern baldness
Both Russell and Ian have male pattern baldness (alopecia androgenetica). It is the most common form of hair loss in men, but it can affect women too. The hairline begins to recede into an 'M' shape and there is some hair loss on the crown of the head. Eventually the receding hairline and the bald patch meet, leaving a horseshoe-shaped fringe of hair around the back and sides of the head.
Male pattern baldness runs in families; the hair follicles are genetically programmed to shrink in response to the male sex hormone, testosterone, levels of which increase in both men and women after puberty. As the follicles get smaller, the hairs get thinner and shorter and less deeply rooted. Eventually, they stop growing altogether.
hard graft
Thirty-five-year-old Lee (who was treated at the Farjo clinic) sees the thousands of pounds he has spent on hair surgery as an investment in his future. He has had two operations to remove healthy hair follicles from the back of his head and insert them in the balding skin on the top of his head. Each small strip from the back is divided into hundreds of plugs of only one to three hairs and planted into tiny holes in Lees's scalp. It's all done under local anaesthetic and doesn't hurt.
The new hairs in the grafted follicles will grow in a normal whirl from the crown of Lee's head. The downside is that there's only so many healthy hair follicles that men like Lee have at the back of their head and three operations is usually the maximum.
'I did have to ask myself a lot of very hard questions,' says Lee. 'I did have to be 110% sure I was doing the right thing. I'm not going to go bald now because the transplanted hair is not going to fall out. You could say it's a long term investment.'
A variation of this procedure is to implant synthetic tufts of hair. Since this is 'foreign' material, there is a greater likelihood that the scalp will reject it and the tufts will fall out, with an accompanying risk of infection.
The other surgical option for extensive baldness is scalp reduction. This means removing the central area of baldness and stitching the remaining pieces of scalp together so that the hairless part becomes smaller.
If you do decide to consider surgery, be sure to choose an experienced surgeon, who is prepared to explain exactly what he or she plans to do, show you photographs of previous operations, and ensure that you know what you are letting yourself in for – physically, emotionally and financially.
'not a wig'
Carl Howell, managing director of Advanced Hair Studio, is horrified if anyone suggests that sticking a small piece of human hair over a bald patch is like having a wig. It's a hair replacement procedure, he explains, not a wig.
'It's like calling a computer an adding machine or a computer chip an optical illusion. It's so sophisticated that it's really insulting to call it that.'
James, a hairdresser who cannot contemplate life without hair, spent £3,000 five years ago on a hair replacement procedure and hands over £50 every six weeks to have it tidied up. Hidden within his gelled and spiky hair, lies his tiny hairpiece – human hair embedded in a small piece of skin-like material.
'A guy's got to have hair. A guy's got to look cool. A guy's got to be attractive. People desire lustrous hair. It's just a fact of modern living,' he says. 'This is the new me and this is the me that's staying. I would never, ever go back to being bald.'
coming clean
An estimated 100,000 men in Britain wear a wig, but very few are prepared to come clean and admit they have one. Trichologist Mandy Baldwin believes they get a raw deal:
'If I were to put on a wig, people would say it's really nice. But if a man puts one on, people think there's something funny about it, and they laugh,' she says.
Today's wigs are very different from the 'dead animal' scrunch of synthetic hair beloved of 1970s comedians. For £500 or £600, you can buy a hairpiece made of human hair imbedded in synthetic 'scalp' so life-like that, as Mandy points out, you're tempted to look for dandruff.
If you are going to buy a wig or hairpiece, go to a specialist centre where there are hundreds of styles and dozens of colours to choose from. People whose hair is thinning or who have patches of hair loss do not usually require a wig and only need a hairpiece.
You can have a permanent hairpiece, which is attached to your own hair with a medical adhesive and is worn all the time, or a removable hairpiece, which is attached by a double-sided adhesive and can be taken off at night. A permanent hairpiece will withstand the pressures of showers, swimming, and sporting activities but does require grooming and re-attachment to adjust for growth of the natural hair to which it is attached.
However, men like Russell who have come to terms with their loss, urge other men to bite the bullet and wear their baldness with pride.
'If someone was losing their hair today, I'd say I know what's ahead of you and it's not going to be very nice. But a day will come when you'll step outside and you'll not care. There's nothing I can say that will make the transition any easier, other than "Hang on in there, you'll feel better one day."'
help and info
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You might like to check out our feature on women who lose their hair for more information about hair loss.
organisations
Institute of Trichologists
24 Langroyd Road
London SW17 7PL
Telephone: 08706 070602
E-mail: admin@trichologists.org.uk
Website: www.trichologists.org.uk
The main training and qualifying body for aspiring professional trichologists in the UK, and the professional association for qualified trichologists in the UK. Provides a postal information service on disorders and diseases of the hair and scalp. Website contains details of trichologists practising in the UK who are qualified by and registered with the institute.
websites
The British Association of Nutritional Therapists (BANT)
www.bant.org.uk
Holds a register of practitioners who are fully qualified in both the science of nutrition as well as clinical practice.
British Association of Plastic Surgeons
www.baps.co.uk
The professional representative body for plastic and reconstructive surgeons in the UK. Website features details of hair-loss support organisations and contains a list of wig suppliers across the UK.
Coping with Hair Loss
www.cancerbacup.org.uk/ ...
Informative booklet from CancerBACUP.
Embarrassing Problems – Hair Loss
www.embarrassingproblems.com/hairloss.htm
Information and advice including descriptions on different types of hair loss in both men and women, the causes, what can be done and where to get help.
Hair Care and Hair Loss
www.royalmarsden.org/patientinfo/booklets/hair_care/index.asp
Online information produced by the Royal Marsden Hospital on the subject of alopecia. Describes how to care for your hair during chemotherapy, looks at scalp care, hair loss in children, and choosing wigs and hats, and features details of further support.
Hairline International – The Alopecia Patient's Society
www.hairlineinternational.com
Membership organisation which gives support for men, women and children who have lost, or are losing their hair, due to alopecia and related conditions.
HairlossTalk.com
www.hairlosstalk.com
An consumer-run US-based resource for men and women who have thinning hair. Features discussion forums, an online library of clinical studies and information on hair loss treatments that have proven themselves in clinical studies.
Male Hair Loss
www.netdoctor.co.uk/health_advice/facts/hairloss_male.htm
This NetDoctor article discusses male hair loss, its causes and treatment available.
Men's Health – Hair Loss
www.menshealth.co.uk/health/hair/index.html
Tips, advice and answers to common questions about hair loss. Also has a hair loss message board.
The Skin Care Campaign
www.skincarecampaign.org
Umbrella organisation representing the interests of all people with skin diseases in the UK. Informative website has a section on alopecia, describing the different types of alopecia, the causes, symptoms and treatments.
Stop Hair Loss Now.Com
www.stophairlossnow.co.uk
Information and advice relating to hair loss, including causes and treatment options for men and women. Also features details of latest news and scientific discoveries.
The Trichological Society
www.hairscientists.org
Founded as 'the professional body for the advancement of hair-sciences throughout the world'. Lists practitioners including chemists, lawyers, pharmacists, physicians and surgeons, trichologists and wig makers. Also features research papers, articles and a range of questions and answers.
reading
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The Bald Truth: The first complete guide to preventing and treating hair loss by Spencer David Kobren (Pocket Books, 2000) |
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The Hair Loss Cure by Elizabeth Steel (HarperCollins, 1999) |
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Propecia: The hair-growth breakthrough by Othneil Seiden (Prima Publishing, 1998) |
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(April 2003, resources updated January 2005)
