Baldness: A Walk Through a Circus of Treatments and History

As P.T. Barnum said: "There is a sucker born every minute." Perhaps nothing speaks better to the validity of this than the multibillion-dollar industry for hair loss.

We are all suckers for our hair. It defines us. We groom and style it to communicate different messages to others. We color, twist, braid, clip and even spike it. It is a sign of virility, youth and strength. Human beings love their hair. The fear of losing our hair and going bald ranks right up there with death and dismemberment for most people.

Bethel Woods

I'm bald. For some men to say those words is like admitting alcoholism for the first time. Men will play around with ridiculous comb-overs, toupees, and scalp spray paint before looking at themselves in the mirror and saying "I'm bald."

Sometimes it is easier for a man to digest he has cancer than he is losing his hair. Along his journey he has probably hemorrhaged money on magic hair growth potions and pills, laser combs and herbal shampoos. Men will part with thousands of dollars just for the hope of hanging on to a few follicles.

Infomercials have largely replaced the greasy mustached man from the back of the wagon, pulling into town with hair tonic to peddle to the local rubes. Hair loss treatments are hocked everywhere by otherwise reputable companies and con artists alike. They are all bunk. If doctors really did discover a cure for hair loss (as I've seen advertised), I suspect you'd see no bald doctors.

One could fill a museum with contraptions that have been sold to desperate men for their balding scalps. Vacuum helmets to suck new hair to the surface, vibrating bands to stimulate blood flow, scalp massagers and shampoos to detoxify the scalp hurt nothing but men's wallets.

Some of the more sinister treatments contained arsenic, mercury, and who knows what else. But perhaps no greater hoax was pulled on mankind than convincing men that powdered wigs could be fashionable. Something tells me there was a group of profiting balding men somewhere behind this.

Even as far back as 1500 BC, people were concerned with hair loss and tried to persuade their gods to help regrow their hair. Egyptian and Greek literature are full of references to this.

Julius Caesar reportedly wore a victory wreath to hide his bald spot. And everyone is familiar with the physical and psychological destruction wrought upon the great Samson after losing his locks. Hippocrates the Father of Medicine prescribed a potion of pigeon feces, cumin, horseradish and nettles to cure hair loss. Needless to say he as well as his patients remained absolutely bald. Of course if this foul concoction were marketed online today, I think men would be typing in their credit card numbers right now to get some.

If you are balding, let me save you some time and money here. There are only two FDA-approved medications to treat male pattern hair loss: Minoxidil (Rogaine) and finasteride (Propecia).

There are a few other prescription medicines that can be tweaked here and there, but minoxidil and finasteride represent where you should put your money. Don't spring for that elixir on the pop-up ad or infomercial.

Finasteride is a prescription so you'd want to talk to your dermatologist about potential side affects. Minoxidil (Rogaine) is a blood pressure medication that happened to have a side affect of growing hair, so its manufacturer formulated it for OTC topical use. It's also one of the few accepted treatments for female pattern baldness.

I usually put people on a biotin vitamin as well for good measure in addition to prescription medication. Hair transplantation and grafting have come light years from the "doll plug" and "corn row" look of a decade ago. It is expensive but permanent and actually the most natural solution in my opinion. Donor hair from the back of the scalp is transplanted into the bald areas. The donor hair follicles are hair from the horseshoe like area of the head, where men don't typically lose their hair. Since these types of follicles biologically respond differently to your hormones, they should not fall out once transplanted. Luckily we have a local doctor here in the area that does excellent work

You may have heard that baldness is caused from an overabundance of testosterone in the body and that bald men have higher levels of testosterone. Neither of these statements is true. A form of testosterone called DHT is to blame, however. It is a powerful sex hormone that promotes facial and body hair growth while leading to hair loss on the scalp. In genetically prone individuals, DHT starts the process of shrinking the hair follicle. Each time it sheds, it grows back smaller and smaller. Eventually the scalp is left with "peach fuzz" or just barren. Way back when, Aristotle noticed that neither eunuchs nor women grew hair on their chests and he correctly surmised this was due to the lack of testes. DHT also affects prostate tissue and leads to noncancerous prostate enlargement.

You may also have heard that baldness comes from your mother's side of the family. If only it were that simple. This myth can be traced back to a paper published in 1916 and has been propagated throughout the medical and lay literature since. There is no single way to get hair loss from your parents, as it is a complex genetic trait most likely coming from both sides.

Balding is not unique to humans. Gorillas, chimpanzees and orangutans all show some different degrees of baldness. Some psychologists have even proposed that a gorilla's high forehead (simulating baldness) creates a larger show for the face, and hence a more powerful social standing.

It was the late 1990s when I started to lose my hair and the only famous bald man I knew was George Costanza from "Seinfeld" - not too inspiring. Being bald used to mean you were either seriously ill, a religious freak, a slave or maybe the loser of a bet. Then suddenly Michael Jordan and Andre Agassi made it acceptable for men to shave their heads.They unlocked a new world for bald guys. No longer would we be compared to Tele Savalas or Mr. Clean.

So one day I woke up at 2 a.m. and shaved my head for the first time. I then climbed back in bed with my wife. I should mention here that I didn't discuss it with her beforehand, so one can imagine her surprise waking up next to a Hare Krishna. Fifteen years later, I'm still shaving it (only there is less and less to shave each year). An interesting psychological point is that it took about three years of being bald in the real world to see myself as a bald person when I dreamed. I think it took that long for my ingrained self-image to adjust.

In conclusion, I'd like to share an amusing Biblical reference I came upon in preparing this article: Kings 2: 23 From there Elisha went to Bethel. As he was walking along the road, some youths came out of the town and jeered at him. "Go on up, you baldhead!" they said "go on up, you baldhead!" He turned round, looked at them and called down a curse on them in the name of the Lord. Then two bears came out of the woods and mauled 42 of the youths. I guess even holy man can be sensitive about their hair loss! And God obviously loves bald men.

Baldness: A Walk Through a Circus of Treatments and History

Dr. Derrick Adams is a board certified dermatologist and the medical director of Vita Dermatology and Laser Institute, a division of Lassen Medical Group in Red Bluff. He is also the inventor of Sasquatch Itch Cream. http://www.sasquatchcream.com. His office can be reached at 528-VITA