The inner struggle of going bald

Most men begin to notice a receding hairline in their 20s. By the age of 50, half of all men have visible hair loss. At 60, it affects around two thirds. The majority of men, therefore, will at some point in their life, have hair loss. Even though male hair loss is incredibly common, it affects their self-esteem negatively. Yet men rarely discuss openly how much upset their hair loss is causing them.

It’s usually when men with thinning hair have a hair transplant that their friends or family realise that it was even a cause of distress for them.

One of my friends started going bald in his 20s. He confessed he used to feel uncomfortable going outside. Later, he had a stubble tattooed on his head to give him a full hairline. His wife, whom he met after the procedure, doesn't know about it. They’ve been together five years now and he still doesn’t have the courage to tell her about his hair loss.

Four of my friends are taking anti-hair loss medication because they, too, consider it shameful and embarrassing. And they would rather keep it a secret because they’ve seen others being mocked for being “vain” if they opt for these options and ridiculed for being “old/unattractive” if they don’t.

It’s like it doesn’t even matter how many people or how many times society in general claim to find baldness attractive, losing hair insinuates a loss of masculinity. For every guy who choose to adopt a close-shaved look like Jason Statham or Bruce Willis, there will be countless more who feel like Samson did when Delilah cut off his hair – weak and powerless. While the image of a fat, balding old man who is mocked because of his looks strikes horror into the heart of many young men who find themselves thinning, it's more than just a fear of being laughed at. Because of its association with ageing, baldness reminds us of our mortality. It shows how we perceive ourselves and how we think others view us. The loss of hair changes a person’s looks, particularly when the eyelashes and eyebrows are affected as they define a person's face. Hair loss may then be seen as a failure to conform to the norms of physical appearance within society.

Anxieties around hair loss often get bound up with other apprehensions about our bodies and feed into insecurities about our appearance or low self-esteem. Single men often worry that they will never find a partner, and those with a partner worry that as they lose their hair their partners will stop finding them attractive.

Studies confirm that the experience of hair loss is psychologically distressing, causing deep emotional suffering, and often leading to individual, public, and work-related problems. People with severe hair loss are more likely to experience psychological misery than those with mild hair loss. Compared with the general population, people with hair loss have an increased prevalence of psychiatric disorders, including a major depressive episode, an anxiety disorder, social phobia, or a paranoid disorder.

The connection between alopecia and psychosocial consequences is further complexed by hair loss that eventuates from a stressful event, which then leads to additional anxiety, distress and even depression. Men who experience high levels of stress are 11 times more likely to experience hair loss than those who do not report high stress levels.

What we need to understand is there is no miracle surgery or magic pill to reverse hair loss. Medicines, at best, would simply hold back the rate of loss for most men and hair grafts and transplants have their own limitations. What can – and should – be considered by men struggling with baldness is psychotherapy, cognitive behavioural therapy to be precise. A good, well-qualified psychologist would address their distress and help them change their thinking regarding hair loss. It sounds unlikely, but it really does work. Not to say it is much easier – and cheaper – to learn to accept the hair loss than it is to reverse it.