Baldness and the uninsulated brain

"MY problem is not changing my hair

"MY problem is not changing my hair. It's keeping it," said British Labour leader Tony Blair last week, in a moment of candour which made headlines in even the quality British press. Such statements, girded in gravitas, rarely come unbidden: Blair was responding to unseemly suggestions that he'd changed his hairstyle in order to attract women voters.

But many men don't take it so lightly and are obsessed with their balding pates. Forget reason, don't try to argue with them that there are more important things in the world. Forever fixed in their uninsulated minds is their scalp in puris naturalibus.

As nature's garb, of course, is the last way they view it. Commercial pressures and glitzy media bamboozle them with highly selective images of the "perfect" man. The tinsel cut outs of Hollywood decreed idols can have an effect. Mind you, Hollywood didn't start it. The bible paints a picture of an apparently handsome Absalom, whose divested crop after each trip to the barbers weighed two hundred shekels - the weight of a two litre carton of milk.

What is it about men who try to conceal their distinctiveness and present a fake, time warped self to the world? Especially given the likes of ever popular shineys like Sean Connery? It's not hair loss but the attempt to disguise this natural process that opens men up to ridicule. Think of Elton John and Bobby Charlton.

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What is the price of vanity? The question was posed to this column by Dr Ronald Trancik of Clinical Research in Consumer Healthcare with Pharmacia & Upjohn in the US. On average, a month's supply of a recently launched across the counter hair maintenance product, Regaine, costs £25.41. Someone who begins to use it at the age of 20 and goes on using it until his seventieth birthday, will spend £15,246 on the product, excluding price rises and inflation - a quarter the price of an average house.

If you're willing to pay out that kind of money on preserving what hair you've got, you might consider using a fraction of it on a shrink and dealing with your self esteem. Dr Trancik admits that this is a huge financial commitment "on the man's part and on the part of the partner". (How's that for a handicap to getting hitched: "There's something I must tell you before we get to know one another better. I've got this financial commitment to my hair.")

Dr David Fentun, Dermatologist of the Hair Clinic at St John's Institute of Dermatology, St Thomas's Hospital, London, feels that Regaine will not achieve dramatic results. It works best on men in their twenties or thirties and on those who have been balding for a short period. If you stop using the product, "you lose it more quickly than you gained it".

Dr Fenton believes that if you forestall baldness by 10 years your scalp will make up for lost time, perhaps within five years, relatively quickly arriving at the degree of baldness you would have reached if you hadn't interrupted male pattern baldness in the first place.

But if this is the case, would it not be better to face the fear of gradual male - pattern baldness now than in the throes of an accelerated loss in the event of stopping treatment later on? Do men really want to become so dependent on commercial products for their self esteem?

Niall Kiely, Manager of Consumer Care at Pharmacia & Upjohn in Ireland disagrees with Dr Fenton that the scalp makes up for lost time if you stop the treatment. He believes that if you stop treatment you proceed with male pattern baldness at your normal rate. On this question, Dr Trancik feels it is "difficult to say", adding that subjects who took part in two year trials "lost whatever they'd gained within six months".

Male pattern baldness accounts for about 95 per cent of balding heads. It affects five per cent of men by the age of 20 and 80 per cent of men who are 70. Alopecia areata is the condition of patchy baldness. Its cause is unknown and usually clears up completely within 6-12 months without treatment. Alopecia totalis is the rare loss of all scalp hair. When all bodily hairs fall out, the condition is called alopecia universalis. Rough brushing, aggressive toweling or ponytails can cause traction alopecia while localised friction alopecia is caused by wearing things like tight caps.

Although chemotherapy can cause hair loss, hair regrows fully after treatment has ended. Cooling the scalp with an ice pack can protect hair in some cases. When hair has regrown, it may be thinner, curlier and of a slightly different colour than before. With radiotherapy, hair loss occurs only around the area being treated. It usually regrows completely after treatment although its loss may sometimes be permanent. When it regrows it tends to be thinner than before.

Hairdresser James Mooney of Duke Street in Dublin advises that a good scalp massage improves circulation and can help to keep your hair. If you are balding, cut it really short. Try not to disguise it. There's nothing worse than a wadge of hair flying in the wind.