As a young
boy, Marty Noble's brownish, thinning hair sprouted unruly cowlicks. Then,
no sooner had he made peace with his wispy locks than he began to lose
them.
Strand by strand
his hair got thinner. It began to fall out, in the front and on the crown.
Noble was just 18.
"I was upset.
I used to cry. It was horrible," recalls Noble, now 27 and a buff Philadelphia
masseur.
"When you are
a teen, your looks are the first thing that other teens judge you on. Your
hair is part of your appearance. I couldn't get the hairstyles that were
cool."
If you're between
18 and 40 and your comb or brush sports more hair than your head, take
heart.
Many young
men — Noble included — feel your pain.
Yes, Michael
Jordan, Andre Agassi and a slew of other famous and not-so-famous men sport
cleanly shaven, fashionably shiny pates these days.
But, if the
popularity of such hair-growing drugs as Rogaine and Propecia is any indication,
most men — even young balding ones — aren't ready for the Charles Barkley
look.
"There is a
societal pressure to have a full head of hair. Many studies show that there
are psychosocial ramifications when one has hair loss," says Amy McMichael,
M.D., associate professor of dermatology at the Wake Forest University
School of Medicine and a fellow of the American Academy of Dermatology.
The reason has
to do as much with a young man's perception of his own well-being as with
his self-esteem or vanity. It also has to do with stereotyping — a young
man with a mop of hair is often seen as fitter, more attractive and desirable
than one whose hair is going or gone, Dr. McMichael says.
Little wonder
why a young man begins to obsess so over each precious strand of hair that,
quite literally, is swept down the drain.
"Certainly,
hair is looked at as a measure of health, a measure of success and youth
in our society," Dr. McMichael says.
The Cycle Of
Typical Hair Loss
The perennial
shedding of some hair is part of the natural hair-growth cycle throughout
an individual's life.
"If you have
no hair coming out you are probably not alive," Dr. McMichael says. "In
terms of scalp hair, normal hair loss is about 50 to 100 hairs a day,"
she says.
These hairs
are automatically replaced by the growth of new hairs. Experts say that
at any given time 90 percent of your hair is growing and 10 percent is
resting.
"That's where
the 50 to 100 hairs a day — the normal hair loss — comes from," Dr. McMichael
says.
The Gene Connection
So why does
the hair on some guys' heads begin to shorten, become thin and drop out,
never to grow back again?
The most likely
cause of this mostly aesthetic problem is something young men have no control
over: male-pattern baldness, the same phenomenon that strikes men twice
Noble's age. It is by far the most common type of hair loss in men 18 to
40 years of age.
According to
the American Academy of Dermatology male-pattern baldness, affects nearly
50 million men in the United States. About 20 percent of white men in the
United States begin to experience this condition by age 20, and the incidence
increases about 10 percent each decade. By age 50, half these men will
have some male-pattern hair loss, says Dr. McMichael. Comparable research
is lacking for blacks, Hispanics and other racial groups.
The medical
name for male-pattern baldness is androgenetic alopecia. You also might
hear it called hereditary-pattern baldness.
That's because
women as well as men can carry the genetic marker that precipitates it.
In men, however, the condition is usually called male-pattern baldness
because the pattern of hair loss (most often affecting the frontal hairline)
differs from the pattern experienced by women (occurring most often on
the crown of the head).
Male-pattern
baldness develops differently in different men. In some, balding begins
directly above the forehead, spreading to the back of the head, leaving
a normal amount of hair at the sides and a swath, resembling a dramatic
widow's peak, in the center of the head. Others experience "vertex" hair
loss, where significant concentrations of hair fade away on the crown of
the scalp. Then there are young men like, like Noble, who have a mixture
of both patterns.
"Half of my
family is going bald," Noble says. "I accept it as the family genetics.
My father and my grandfathers on both sides of my family were bald by the
time they were 30."
The diagnosis
of hereditary pattern baldness relies on medical history, hair-care history
and visual inspection.
Most people
know it when they see it, Dr. McMichael says. "It doesn't present a diagnostic
quandary."
There can be
other reasons why a young man in the prime of life starts to lose significant
amounts of hair, particularly if the hair loss is relatively sudden. Some
skin disorders and diseases can cause it. Some disorders of the immune
system can also lead to hair loss, as can nutritional deficiencies.
Side effects
of certain medications, such as lithium (used to treat bipolar disorder),
or beta-blockers (used to treat certain cardiovascular disorders and migraine
headaches) also cause hair loss.
Finally, hair-damaging
products and styling practices can also lead to hair loss. The first line
of treatment for these types of excessive hair loss is treating the underlying
cause.
Bruised Egos,
Rogaine And Razors
There are several
remedies for male-pattern baldness.
Temporary hair-enhancing
options include hair weaves, toupees and other hairpieces. Permanent remedies
include surgical procedures such as hair transplants, scalp reduction and
hair flaps.
Noble has yet
to consider such procedures, though some of his balding friends have. A
few have even gotten hair transplants. But Noble did have a fling with
two popular hair-growth medications.
"I went to my
regular doctor and he set me up with Propecia (finasteride) and Rogaine
(minoxidil)," Noble says. Results were slow in coming, and "I just didn't
have the patience for it," he says.
"Plus, it was
expensive."
It seems that
some balding men with more patience — young and old — are finding relief
through Propecia and Rogaine, both approved by the U.S. Food and Drug Administration.
Most men using Rogaine will experience a slowing or stopping of hair loss
and some will even experience an increase in hair density. Hair loss slows
down in 88 percent of users who take Propecia in the pill form, with more
than half of them experiencing some hair growth on the crown.
There is, of
course, another remedy. It's quick and cheap, and it's what Noble decided
to do: Go bald.
"I shaved it
probably when I was 23-24," he says.
Three years
later he's still bald. "I'm truly, truly comfortable," Noble says about
his smooth, hairless dome. "I'm comfortable with myself. If you are confident
in your abilities, and with whom you are, that's what counts. Hair [alone]
is not going to get you through life."
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