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Most men don't need to be told — it's the loss of hair resulting in decreasing coverage of the scalp.
Male pattern baldness (also known as genetic hair loss or alopecia androgenetica) is the most common form of hair loss in men. It usually develops very gradually, typically involving the appearance of a bald spot on the crown of the scalp accompanied by thinning at the temples. Although this problem can strike any man at any time, many first become aware of it as they approach their thirties.
There is only a tiny grain of truth in the myth that bald men are more virile because they have more of the male sex hormone testosterone.
This idea probably grew from the observation that eunuchs never became bald and, having being castrated, they didn't, of course, produce very much testosterone.
Yes, testosterone is involved in male pattern baldness, but its relationship with hair loss is complicated and not completely understood. Testosterone is naturally converted in the body to a related sex hormone, dihydrotestosterone (DHT). This stimulates the growth of facial and body hair, as well as acting on the prostate gland. There is good evidence that male pattern baldness results from an over-sensitivity of scalp hair follicles to DHT, rather than raised levels of either sex hormone in the blood. As with pretty much everything, there's probably a link to smoking.
You cannot prevent male pattern baldness, although there may be ways of slowing down the process or disguising the problem.
Since male pattern baldness is related to testosterone production, the only sure fire cure is castration before puberty which curiously enough few men opt for.
But hair loss never killed anyone and some of the sexiest men on the planet – according to sources male and female - have little or no hair.
If you’re really struggling to come to terms with baldness, talk to someone. Hair loss may be a trigger to unhappiness and depression but it’s unlikely to be hair loss alone that is behind your feelings.
The bald and proud site Bald R US has a hall of fame. It’s very US-oriented but includes Shakespeare, Churchill, Sean Connery, Samuel L Jackson and Patrick Stewart.
If you are lucky enough to have an enlightened GP, by all means seek their advice — at the very least, you'll get a referral to a reliable trichologist (although you'll probably have to pay for any treatment you receive).
A trichologist, by the way, is a hair specialist whose training covers both the cosmetic and the medical aspects of the subject. Some trichologists are also trained hairdressers, but they are not usually medically qualified. The Institute of Trichologists keeps a register of properly qualified people: look for the letters AIT (Associate), MIT (Member) or FIT (Fellow) after their name.
Other types of hair loss, such as alopecia areata, are taken seriously as medical conditions and you should seek your GP's advice as you would for any other medical problem.
There is no cure for male pattern baldness, but there are both drug and surgical treatments available which may lead to some improvements.
Minoxidil (sold as Regaine)
Finasteride (a generic version of the medicine formerly marketed as Propecia or Proscar)
Hair transplant surgery
Remember, a good hair surgeon probably doesn't need to advertise.
As far as other treatments are concerned, be very wary. There are many bogus operators out there who are only too keen to exploit people with hair loss.
Making changes in your hair care routine and overall lifestyle may help minimise the appearance of hair loss.
There's no cure for male pattern baldness, although other forms of male hair loss are often reversible.
First Drafted by Dr Susan Aldridge. Revised 2014 by Keir Stone-Brown.
MAIN IMAGE: created from images by Steve Rogers (Woody Harrelson), Jeremy Thompson (Samuel L Jackson) Eric C Salkor (Joseph Fiennes) and Gage Skidmore (Bruce Willis) licensed under CC BY 2.0 unless otherwise indicated on link.
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Date of last review 02/04/14
Date of next review 02/04/17
It’s tough for men to ask for help but if you don’t ask when you need it, things generally only get worse. So we’re asking.
In the UK, one man in five dies before the age of 65. If we had health policies and services that better reflected the needs of the whole population, it might not be like that. But it is. Policies and services and indeed men have been like this for a long time and they don’t change overnight just because we want them to.
It’s true that the UK’s men don’t have it bad compared to some other groups. We’re not asking you to ‘feel sorry’ for men or put them first. We’re talking here about something more complicated, something that falls outside the traditional charity fund-raising model of ‘doing something for those less fortunate than ourselves’. That model raises money but it seldom changes much. We’re talking about changing the way we look at the world. There is nothing inevitable about premature male death. Services accessible to all, a population better informed. These would benefit everyone - rich and poor, young and old, male and female - and that’s what we’re campaigning for.
We’re not asking you to look at images of pity, we’re just asking you to look around at the society you live in, at the men you know and at the families with sons, fathers and grandads missing.
Here’s our fund-raising page - please chip in if you can.