Bald is not beautiful

Hair loss in men can be quite traumatic. But there's no need to suffer in silence. Hair transplants are the answer.

July 16, 2011 04:10 pm | Updated 04:38 pm IST

Cause for great concern... Photo: K.R. Deepak

Cause for great concern... Photo: K.R. Deepak

Hair restoration or hair transplants used to be taboo but not any more. It may sound like a cliché but, for many, it's given them their lives back. Male hair loss can be deeply traumatic. Some pass it off as not significant and live with the ‘bald jokes' quite happily. But, for others, it is a different story. For a great many men, going bald is life altering and, unless treated, can have tragic consequences.

Signs of baldness can cause bouts of anxiety, psychological stress, emotional distress, lack of self-confidence and even depression. Pavan — who once had a glorious mane but now self-deprecatingly calls himself ‘another bald man' — admits his “self image took a beating”. For a fair number, the thinning of hair psychologically denotes loss of virility, attractiveness and even decline in sexuality.

Off limits subject

Such is the stigma around hair loss and transplants that many men did not even want to talk about the subject; they thought it was an invasion of privacy and believed the subject was off limits.

Atul says, “You become obsessed. Every moment is spent looking at yourself in the mirror, looking at your hair, analysing what could be and how and why”. Sanjana agrees. Her husband Mukesh had “real identity and confidence issues” when he started going bald “because he took it as a sign of ageing”. Some men take to wearing a hat and hiding behind it.

Hair transplant candidates are strangely reticent, as if discussing or showing an inclination or opting for a transplant depicts a weakness; as Atul says, of “not being a real man.” Rajiv says, “It might have something to do with the image of bald men and potbellied stars trying to behave like youngsters when, in reality, they look very old. That reminds us of old age”. Another reason could be that a bald head remains one of the few physical flaws used as a butt of jokes.

Either way it is ludicrous that, in today's cosmetic frenzy to shy away when it can be easily rectified and that's just what seems is happening. Secrecy and shame and embarrassment continue to shroud hair transplants and premature male baldness in general. Strange given that hair loss affects 60% of men before the age of 40 and that, of those affected one in four will begin the process before the age of 21.

Hair baldness or alopecia usually follows a typical pattern of receding hairline and hair thinning on the crown. This happens because of an excess of a chemical called Dihydrotestosterone or DHT, which causes the hair follicles to make thinner and thinner hair until they eventually pack up completely.

Today, it's more acceptable for men to worry about their hair and spend money on correcting things they don't like about themselves. It seems that the psychological factors in male hair loss have been vastly underestimated.

Hair transplant techniques have become more sophisticated. Old methods involved taking large sections of skin from the back of the head and grafting them on top of the scalp, resulting in erratic and unnatural looking regrowth. But follicular unit extraction or FUE is almost undetectable. FUE allows surgeons to place individual follicles back into the thinner parts of the hair line around the top and the front of the scalp. The results are sometimes dramatic and, more to the point, very natural in appearance. Says Navin, “Transplants have changed my way of life. It was horrible going bald.” Nick adds, “Anyone who says he doesn't mind going bald is lying. It is debilitating and creates another persona, which is not you at all.”

Not everyone is a good candidate, though, and not just those with conditions such as alopecia totalis, which leaves them without any suitable donor sites. Some have behavioural issues that need to be addressed.

Get the right surgeon

Once the decision to have a transplant is taken, it is important to find the surgeon. There are numerous examples of men who have had disastrous results. Arvind, who was badly scarred by a botched hair transplant procedure, says, “My surgeon did not understand my hair type, which is very curly. I felt like part of a conveyor belt, just another patient. The result was also artificial and looked it. He did not treat me with sensitivity or compassion.” Nick, who recently underwent a transplant, says, “It definitely is a big step. And one has to have a surgeon who will give you back that confidence.”

FUE is labour-intensive and highly skilled. It is performed under local anaesthesia; typically over two sessions, each taking several hours. Post operative is very painful and then it gets very itchy. Recovery takes about 10 days though the pain usually subsides after 72 hours.

Consultations are detailed and design sessions are crucial as this is where the placement of every single hair is discussed and mapped. The aim is to highlight the features of the patient taking into account race, facial dimensions etc. “After all,” says Nick, “you can't just add hair anywhere”.

Results are gradual as it takes 12-18 months for the hair to grow and for the full results to become apparent. Psychologically it also gives men time to adjust to the new look. It is expensive but Navin says, “It is worth the money. Today I look younger; feel great and my confidence, which waned, is back.”

For people who have been bothered by hair loss, the reversal of the process is like getting a new life. Clearly going bald is no small matter. And addressing it or living with it; either way has far reaching consequences. In a sense it is how you want to live the rest of your life. In hiding, in the closet or with a full mane of hair and out in the open!

Causes

Iron deficiency

Underactive thyroid

Fungal infection of the scalp

Stress

Hormonal problems

Genetic predisposition

Symptoms

Hair fall in patches

Shedding of hair

Breaking of hair shafts

Hair loss associated with redness, scaling and pain

How your hair grows

Hair grows about an inch every couple of months.

Each hair grows for two to six years and remains at that length for a short period and then falls out.

A new hair soon begins to grow in its place. Each hair sits in a cavity in the skin called a follicle.

Baldness occurs when the follicle shrinks over time resulting in shorter and finer hair. The end result is a very small follicle with no hair inside.

The follicles remain small and alive suggesting the possibility of new growth.

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