What The Pros Think

What the Pros Think

This Article was written by Dr Lyndsey Myskow

Cosmetic Physician and GP

It seems more obvious that hair is important to women than men. Hair is a woman’s “crowning glory” and it is women who have bad hair days. Although men seem laid back about their hair when it is there, its disappearance is a source of great angst.

Men over 50 are more likely to be bald so baldness is seen as the end of youth. If a young man goes bald prematurely he can perceive this as disastrous and it can lead to significant depression. In less serious cases he can still suffer from low self-esteem due to dissatisfaction with appearance and body-image. This leads to loss of sense of self as attractive and therefore a feeling of inability to be attractive to others. This makes them anxious about forming romantic relationships. Men may be embarrassed by their baldness and it can lead to loss of confidence in other areas of their lives for example in the workplace. These feelings are not helped by being teased or humiliated by others about their baldness and can also expand into jealousy of other men who have full heads of hair. Unsurprising then that they reach for any means of reversal of the process.

Least invasive solutions are hairdressing techniques such as the dreaded comb-over which even the slightest gust of wind turns into a sort of offside mahican. Juliius Caesar was apparently distressed by his frontal baldness and combed his hair over from the back then cleverly kept it in place with a laurel wreath. Some men have the feeling that longer hair is better which in the worst case scenario results in a long and skinny ponytail which probably highlights rather than minimises frontal hair loss. The current fashion for shaved heads would seem to be an answer to a bald man’s dreams but even then a shiny head rather than a bristly head is seen as a problem. Some men grow a beard or moustache to take away attention from their head or indeed improve their physique by exercise in order boost their self-esteem and again to distract attention from their lack of hair.

Baldness cures have always been popular and have varied from the somewhat unpleasant ancient Egyptian cures which involved application of a mixture of fats from the hippo, crocodile, tomcat,snake and ibex along with porcupine hair to the scalp to the wacky 1936 contraption called the Xervac .This was a machine inside a helmet which used suction to encourage hair growth. Advertisements for the system which could be rented for home use or found in barber’s shops encouraged business men to lie back and relax with a newspaper and a cigarette while the machine worked its magic on their hair follicles.

Wigs have been around since ancient times and in the 17th century very elaborate wigs were fashionable which must have been a real life-saver for bald men. These days, toupes are available but must be of high quality to look convincing.I remember one of my Univeristy professors causing a great stir when he suddenly appeared without his toupe – a brave move indeed. Perhaps he had reached an age when he felt baldness was acceptable or of less significance when he had so many academic achievements.

In 1939 a Japanese dermatologist pioneered a procedure for grafting hair form the scalp, eyebrows, face and other parts of the body onto bald areas of the scalp. Two decades later the new York doctor Norma Orentreich popularised hair transplants which for many years resulted in scalps reminiscent of dolls heads. This treatment for male pattern baldness now gives much more natural results but is costly and time-consuming.

Medical treatments available now are the drug finasteride which is an effective oral treatment which has to be prescribed by a doctor in the UK and the locally applied drug minoxidil, which is less effective, but available over the counter.

Hippocrates noted that eunuchs always had good heads of hair and it is now known that the cause of baldness is sensitivity of the hair follicles in some men to testosterone. Castration would be a possible though no doubt deeply unpopular treatment.

Finally, men who like the shaven head look can have their inactive hair follicles pigmented to match the appearance of the active follicles to create the appearance of a shaved full head of hair.

Fortunately these days there are options for men who struggle with their baldness particularly if they attack the problem early on, before it leads to psychological distress.

Case Studies

Peter had always dreamed of a career as a television news reader. He was good-looking and had the sort of deep voice which sends vibrations through those standing close by. He was working in local radio and it seemed his dreams were about to be shattered when at age 27 his hair started rapidly falling out. His father and grandfather both had the same problem and just told him to put up with it He however knew there was no chance of working in TV news as a bald man.. He was lucky enough to be prescribed finasteride early by an understanding doctor and now 15 years later he has achieved a very successful TV career and has an almost full head of hair.

David started to go bald in his early 30’s. He initially modified his hairstyle and tried applying minoxidil which produced sparse fluffy hair which wasn’t acceptable. He wore hats to disguise his thinning hair but then eventually he gave up and shaved it all off. He however remained very aware of the visible male pattern baldness in his hair follicles and this cast a shadow over his otherwise very successful life. He had a beautiful wife, 4 healthy children and a stellar career but his head was a problem. He eventually came across scalp micropigmentation and now has a new youthful hairline He is delighted with his new appearance which has boosted his confidence and sense of attractiveness and has lifted his low mood.

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