Hair today, gone tomorrow: the bald truth about men's hair loss

While coming to terms with his midlife receding hair, Pat Fitzpatrick talks with friends who started to lose their hair at a young age

Pat Fitzpatrick: 'Hair loss is an issue for most men, whatever age it starts to happen'. Picture: Eddie O'Hare

I JUST took a picture of the top of my head. The hair is getting pretty thin up there, I’m well on the way to the bald-on-top monk look that two of my uncles had for as long as I knew them.

Some 85% of men will experience ‘significant thinning hair’ by the time they reach 50, according to The American Hair Loss Association. I’m not delighted that I’m thin on top, but that’s about level par for my age (53) and I don’t feel the need to do anything about it.

That said, I do a bit of TV work with RTÉ on the Today show, where I sometimes catch sight of my spreading bald-spot from a display in the studio. Someone I know working in the media has offered to give me a loan of some polish concealer, so I don’t end up getting relegated to RTÉ 2. I know they’re joking, but it makes a good point. Hair loss is an issue for most men, whatever age it starts to happen, affecting self-esteem, career prospects and perceived chances of finding a partner.

Androgenic alopecia (also known as male pattern baldness or MPB) causes the vast majority of hair loss in men. We shouldn’t overstate its impact. A review of the literature on the psychosocial impact of MPB, published on pubmed.gov, concluded that ‘androgenetic alopecia is typically experienced as a moderately stressful condition that diminishes body image satisfaction’. So in general, it’s not that bad for men. (The same review notes that androgenic alopecia has a greater effect on the self-esteem of women who experience it.) But then, all men experience it differently.

A friend of mine going back 40 years started to notice his hair thinning out when he was aged 16.

“I just noticed it falling out,” he tells me over the phone. “I remember feeling a bit awkward going to see a doctor specialising in scalp issues, he was an older man sitting at a big desk, who asked me if I minded if these people sit in on the consultation, and pointed at five or six trainee doctors sitting at the back of the room. What could I do? The whole thing lasted five or 10 minutes — he said you have male pattern baldness, there is nothing you can do, just get on with it.”

He tried Regaine and massaging the scalp, but it didn’t work. “I’d love to have gone around with a David Essex head of hair, but what can you do?

“It takes a number of years to go actually bald, with male pattern baldness. The two sides start going but you still have a bit in the middle, and you can’t hide it anymore. You can decide, I’m going bald and cut your hair accordingly or do a comb-over and cover it up. I’ve known guys that got hair transplants. But I was never one for the cover-up-job.”

Shaving it off in one go wasn’t an option for a middle-class kid like my friend in 1980s Cork. “When we were growing up you’d never see a guy with a shaved head, or if you did, he was a lunatic. Now, it’s just another hairstyle.

“It was going thin through college, there was a trip to London with a friend, we went to a barber, he got a buzz cut, so I got one as well. From then on, I started to keep it much shorter, it just didn’t look as ridiculous.

Then bald became fashionable. Bruce Willis and of course Keith Wood — that gave permission to men to own their baldness. They could be bald without sticking out.”

I was always under the impression that my friend owned his hair loss from day one, that it didn’t bother him one way or the other. But that’s not how he sees it.

“It was a tough age, late teens to mid 20s, where you’re not bald-bald, but it’s thinning out, that was tough for my own vanity, I’d much prefer a proper head of hair,” he says.

“I’m small, I was bald so you did get the whole Benny Hill thing going on, that was really frustrating. Like any young males with testosterone, they’ll find any weakness to try and get their place in the order of things.”

MEDICAL INTERVENTION

Picture: Eddie O'Hare

The list of men with hair transplants includes Louis Walsh, James Nesbitt and Wayne Rooney. My brother-in-law, who is also a friend, could be joining that list soon, based on our recent conversation about his hair loss.

“We were at a snooker tournament in Killarney, we were playing down at a lower level to the supporters,” he says.

“Everybody was celebrating that we won our match when my buddy walked over and said, ‘you need to shave your head, boy’. So I shaved my head, at the age of 29.”

Did it bother him? “No, it was the perfect way to tell a man he was going bald. I accepted it, everyone else was pussy-footing around it.”

Eventually, though he missed having a full head of hair, and looked into follicle unit extraction (FUE), where hair is moved from denser areas of the scalp to the part that is going bald. “I was that close to doing it a few years ago, I had a break between jobs, it was just before I got married, I was going to have a full head of hair for the wedding. I was going to go, had flights booked for Poland to get it done, when a new job came up, and I said, if my hair starts growing in there, they’ll start [teasing] me. It was going to cost me over six grand, but I didn’t care.”

I tell him he shouldn’t bother, that a bald head suits him (he’s had more than one person comparing him to the actor Jason Statham, which is pretty flattering.) “Ah no, the plan was to have a full head of hair to shave. Everyone looks better with a bit of hair on their head. Don’t get me wrong, the shaved head hasn’t knocked my confidence. I used to get a slagging when I was in denial about the hair loss, but it’s fine once you accept it.”

He still hasn’t given up on the follicle extraction treatment. “I’ve been looking into it, it’s cheaper in Turkey, about three grand. I think, why not, I can afford it. It’s like getting a new pair of shoes, it would make you look better.

“At times my head makes me look older. I shave it once a week — Monday I’m grand, but come Friday I’m starting to look like an older man again.”

MENTAL HEALTH

While most men get on with things and make a joke out of hair loss in public, it can have a serious mental health impact for some. Tom Conlon is a psychoanalyst, treating patients referred to him for anxiety, depression and post-traumatic stress disorder. I asked him about the impact of low self-esteem.

“Low self-esteem is par for the course for many of my clients,” he says. “And a lack of self-esteem can wear you down.

“One of the things we underline in my profession is ‘the gaze’. As people look at me, what are they thinking and what do they see? Now, people mightn’t be thinking anything at all — but in my mind’s eye, I might think that person is laughing at me or thinking I’m deficient in some way.

“My job is to listen very attentively. People might speak about baldness, but as a general rule, there is something else going on. Everyone can see that someone is bald, that’s a fact, but the thinking process behind that is often anxiety about something else.

“One thing we all have in common is the link back to how our parents looked at us. So, as the parent looked at me when I was young, what was going on with them, did they like me, or not like me and so on. I think what happens in terms of baldness and other things — people looking at me, that reminds me in some way of the way my parents looked at me.

“We all have our own experience of this in terms of our background. Just because this [baldness] applies to millions of men isn’t enough for me.”

He’s right. I don’t think I’ll be polishing my head when I’m on TV or heading to Turkey for follicle extensions. I don’t think medical tourism is for me, it’s not worth the risk.

We all have to come to terms with hair-loss in our own way. And it’s easier once you accept that it’s happening to you.