Does going bald mean you lose more than just hair?

The beginning of 2020 was not off to a good start for David*, a 20-year-old university student. Like many men, David’s hair is an integral part of his identity; people make inferences based on someone’s physical appearance. The cut, colour, style and even the way he parts his hair all work to convey a certain image to people. It is part of his identity. Which is why David freaked out after the new year when he noticed his hair was falling out.  Thinning, receding and loss of a signature gloss to his curls suddenly felt like a threat to his identity.

Researching and trying to draw parallels from what he could glean from the internet, David realised that some of his lifestyle choices were having a direct and tangible impact on one of the defining features of his identity. Together with his education, place of birth and taste in art and pop culture, he considers his hair to be one of his defining features. With his hair being his only physical defining feature, one can understand how distressing it must have been to suddenly feel it was being forcibly taken away from him. “It was an existential fear. It was all encompassing and I felt it was having a direct effect on my ability to be successful in life.” Although David laughed nervously when he said this, there is no denying that a lot of men believe hair loss is one of the worst things that can happen to them, especially when they are young.

David’s feelings of defeat are common amongst bald (and balding) men, with studies reporting that bald men are linked with poorer self-esteem and body image, and higher stress and depression.

If I asked you to close your eyes and to picture a bald man, you would probably conjure the image of an old man, with wrinkles and sparse dottings of grey hair. Hair loss is a cliché indicator of ageing and with David only being 20, losing it now seems premature. “It felt as though I hadn’t even had the chance to enjoy my attractiveness.”

But why does David place so much weight in his hair contributing to his level of attractiveness? David is a young, intelligent, attractive young man, so his admission of insecurity may surprise some readers; you might think he would recognise these other qualities in himself and not feel he needs a full head of hair to attract girls. But David doesn’t see it that way.

“What girl is going to walk up to a guy in a bar who is balding at the age of 20…hair is a prerequisite for sexual attraction. Especially for younger men. Like the guys that girls froth over, tend to have lots of hair. Like Timothee Chalamet.”

The internet certainly has a collective obsession over Chalamet’s thick, curly brown hair that seems to so effortlessly flop on hix head. Chalamet is just the latest version, with predecessors Harry Styles and Shawn Mendes coming to mind.

Justin Bieber is another prime example, although without the curly brown hair. The beginning ofBieber’s career was arguably made by his now iconic blonde bowl cut – boys all over tried and emulate the look. David even goes so far as to say that, “girls love him because of his hair. Without it, he wouldn’t have been as successful.”

Historically, a man with a full head of hair has been associated with vitality and virility. Consider the archetypal biblical hero Samson, whose power was derived from his hair, or Michelangelo’s David sculpture, often recognised as the world’s most beautiful man, who in statue form still had a full head of thick curls. A man’s hair undoubtedly has played an important role in defining male beauty.

But is there any science to back up what David feared so much, that his objective attractiveness as a young man would plummet with the loss of his hair? It seems there is.

A 2013 study conducted by researcher Albert Mannes, found that women perceive bald men as less attractive than men with hair. Society has equated bald and shorn hair with “symbolic castration,” and restrained sexuality. Participants also suggested bald men were 5-10 years older than they actually were and were overall less attractive. However, this was the case only for men who did not choose to go bald, instead having the hairstyle forced upon them thanks to genetics.

Interestingly, the study found that men who opted to part ways with their locks were perceived as more masculine, taller and even physically stronger. While their overall level of attractiveness to women is lower compared to men with hair, this increased perceived dominance, yet decreased attractiveness is confusing. Mannes offered an answer, suggesting the distinction between masculinity and attractiveness could be explained by the hair styles donned in typically masculine professions – the military, policemen and in some cases professional athletes. This is interesting because being more overtly masculine does not mean a man is perceived as more attractive, case in point again being the internet’s obsession with Timothee Chalamet.

When David began noticing his hair was thinning, he “was just like, f*ck.” An internet research frenzy soon ensued, as though he was truly in a race against time to stop more hair falling out. David needed to find a plan of action to soothe his anxiety, to figure out if he really was going to lose his hair forever.

What causes hair loss?

One of the most common reasons for hair loss is a genetic sensitivity to the hormone dihydrotestosterone (DHT), which causes male pattern baldness – what David thought he was experiencing.

All hair goes through a growth cycle; normally it will grow, stop growing, fall out and then repeat. Male pattern baldness disrupts this cycle – once hair falls out, it does not grow back. Those who experience male pattern baldness carry a gene that makes their hair follicles more sensitive to DHT. With this increased sensitivity, the hair follicles begin to shrink, resulting in shorter and thinner strands of hair, eventually ceasing to produce any new hair in its place, thus ending the hair growth cycle.

David quickly, and incorrectly, self-diagnosed as having early onset male pattern baldness, and found that getting a prescription of Dutasteride from his doctor would likely be his solution for keeping his hair. Dutasteride is a compound taken by patients to prevent the conversion of testosterone to DHT in the body, which is crucial in slowing down hair loss.

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Image: Hair Growth Cycle, Phillip Kingsley, 2016

Continuing his research, David realised his hair loss was not male pattern baldness, there was more contributing to his sudden hair loss than just his genetics. Recreational drug use was also responsible.

After considering his experiences over the preceding few years, David realised there were other causes of hair loss that more closely mirrored his symptoms, leading him to realise he was experiencing something called “telogen effluvium”.

Telogen effluvium is a type of hair loss that is due to a disruption to the hair growth cycle. Some of the main causes include:

  • Major psychological distress
  • Recreational drug use
  • Extreme change in diet
  • Sudden weight loss

This relieved David immensely, as this is a temporary condition and can be reversed – unlike male pattern baldness which can only be slowed down by medication. Telogen effluvium often has a delayed onset, up to five months after the initial triggering.

Like many university students, David embarked on the quintessential backpacking trip throughout Europe during the summer of 2019. While having a lot of fun, the trip did have its ups and downs and caused major stress for David. A string of mishaps, sleepless nights, lack of secure accommodation and experimentation with recreational drugs resulted in a very distressing environment.

“I was just really in a f*cking bad space. I have never felt so stressed. Just like, pure stress and anxiety coursing through my body.”

Connecting these experiences led David to believe his hair loss was triggered by major psychological distress, enhanced by recreational drugs – as David put it, he was “skat, out of my brain … there was no serotonin left in my head.” He was putting his body through too much stress, and this ended up making his hair show visible signs of damage many months later. The drugs he took caused dehydration, and thus his hair became brittle, dry and broke off easily.

To test whether David’s drug use really was causing hair loss, he stopped using drugs. The results were promising. Now that David was taking better care of himself and taking the prescribed Dutasteride tablets, he saw a major improvement to his hair. It began growing back and thickening. He is a firm believer in the saying, “If you look good, you feel good. If you feel good, you play good.” I don’t think David noticed the irony of this as the man who said it, American footballer Deion Sanders, is bald.

Stigmas surrounding baldness

About 1 in 5 men will experience balding in their 20s and with half of men in their 40s experiencing receding hairlines and overall thinning. These statistics make clear that hair loss is a widely shared experience for men, which is why the often-silent struggle and chip-on-the-shoulder attitude is perplexing.

Until relatively recently, effective hair loss treatment methods didn’t exist. Snake oil salesmen sold them in hushed tones, encouraging men to deal with their hair loss in painful privacy. A 1991 ad for Rogaine, which is an effective drug for treating hair loss, did not once mention what it was used to treat and instead encouraged viewers to dial-in an order to be delivered “the complete story” if they were brave enough. Ads such as this can help explain why many men felt ashamed and forced to suffer in silence.

The stigma has begun to change in recent years, with new brands such as Himsintroducing a brazen and unapologetic approach to advertising hair loss, helping remove the shame and helplessness often associated with the condition.

In the US, the patent for Finasteride (another effective treatment for hair loss) expired in 2014, allowing new market entrants such as Hims, to launch hair loss solutions at cost-friendly prices. These companies began advertising themselves as approachable, aesthetically pleasing solutions to hair loss, offering online consultations with medical professionals and prescription and non-prescription based treatments. Their mission is to “create an open and empowered male culture that results in more proactivity and preventative self-care.”

Companies such as Hims made David feel hopeful. He appreciated the more appealing aesthetic they were marketing, and that seeking help became more approachable. Encouraging self-care for men is an important issue for David, and he said it gives more opportunity to be proactive in looking after yourself and reduces the stigma around hair loss.

But why are there negative stigmas for men who lose their hair? It’s not like there is a gap in the representation of bald men in society. Consider (the admittedly charismatic and masculine) Dwayne “The Rock” Johnson or Michael Jordan or Jeff Bezos. These men need no introduction and are known for much more than just being bald and are all still incredibly respected in their fields.

So much of the messaging in society is that hair loss is a bad thing and the men idealised in pop culture continue to reflect the primacy of men with luscious locks – from Chris Hemsworth to Jason Mamoa to Zac Efron. Bald men are also often the butt of jokes. Jason Alexander’s character, George Castanza, from Seinfeld is a prime example of a target of “bald humour”. George often said he was “handicapped” because of his baldness, and that it kept women from being interested in him. George’s struggle is one that David could definitely relate to. Yet including these jokes in the show must have been informed by the baldness of the show’s co-creator, Larry David. Larry has been quoted saying that “anyone can be confident with a full head of hair. But a confident bald man – there’s your diamond in the rough.” So perhaps the jokes about George are all made affectionately, playing into the trope of bald men being grumpy and unlucky in love?

All that being said, perhaps times are changing for bald men. While there will always be a high degree of subjectivity to what someone finds attractive, bald or not bald, there are more options for men like David being able to make a choice about their hair loss. Companies like Hims, while not suggesting they have the cure to permanently eradicate baldness, are certainly working towards lessening the stigmas surrounding hair loss. And at the end of the day, you have to work with what you have – or don’t have. As confidence seems the denominating factor for attractiveness, if a man is confident enough in himself, even if he is losing his hair, he is still viewed as attractive. Sean Connery was once named the People’s sexiest man alive, and the caption beneath his smouldering photo was “older, balder and better.”

 

*David’s name has been changed