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Hair Today, Gone Tomorrow: A Study In Baldness by Marjorie Dorfman

How does one deal with such an obvious effect on one's appearance? Where can one find the best ways to stop or deal with hair loss? Hopefully, a laugh or two will escape from hairless lips in the process.

Hair today and gone tomorrow is a hard pill to swallow.  
. . . The Dorfman Archives

Whenever I hear of some poor soul going bald, the first image that comes to mind is the I Love Lucy episode in which Ricky Ricardo is convinced that he is losing his hair. Lucy concocts a solution to massage his scalp that smells so vile, looks so terrible and is so time consuming to apply that she is convinced it will turn him off to the idea. In true I Love Lucy fashion, the results are unexpected; Ricky feels the eggs, mayonnaise and salad oil topped with a silk stocking he must wear to bed every night has stimulated his hair growth, and that she should apply it to his head several times a day! Baldness is certainly no laughing matter, but sometimes a little levity can cut a path through a tangled, emotional and not so hairy wood.

Back in my college days, I had a part time receptionist's job at The Wybrant Hair Systems. (I mention the name because I have no need to protect the non-innocent.) Clients would enter wearing dark glasses and sit quietly in the reception area until they heard their name called by a strange and hairy older woman with a rather fetching smile. They would all go behind a dark green door and come out some twenty minutes later looking exactly the same as when they ventured inside. Whatever Mr. Wybrant's secret for growing hair was, he never shared it with his clients or the IRS who eventually closed his office down. Perhaps the agents got to the truth about his "financial deductions" by pulling out his hair rather than his fingernails. (One can only hope.)

Ninety-five percent of all hair loss is inherited, so go ahead and blame your parents. It is their fault (even though it wasn't their baldness in the first place either). Still, one wonders where the first bald person erupted from, before the condition was inherited, I mean. Hair follicles receive genetic coding during their formation in the womb. These hair-loss genes create thinning hair until eventually the follicles die and permanent baldness occurs. Every hair on one's head adheres to a genetically programmed schedule that includes growth, resting and shedding. It's like being in a strict summer camp with Reveille at 6:15AM (because 6:00 is just too damn early), breakfast at 7:00 and first activity at 8:30!

The medical term for inherited baldness is androgenetic alopecia. In men it is called male pattern baldness and usually progresses to the familiar horseshoe shaped fringe of hair. In women, hair loss usually takes the form of thinning over the entire crown of the head. Everyone's hair loss is unique, but doctors have designated a scale called The Norwood Classification which represents graphically the different stages of baldness using the numbers from two to seven. They range from slightly receding hairline to generalized frontal thinning to balding crown. Not everyone progresses to the bottom of the class at stage seven. The hope is to slow down the loss or end it completely at any of the stages mentioned.

What can be done for those of us who are between stages two and seven and the devil and the deep bald sea? Fortunately, there is the promise of some hair at the end of the tunnel. Some "miracle" elixir that someone told someone gave someone else a new lease on a hairier life is usually the first thing attempted. Consider poor Ricky Ricardo. He was no better off with the Caesar salad and silk stocking on his head than if he had done nothing at all. More than 3.5 billion dollars are spent each year on tonics that claim to grow hair. I am afraid that all they grow are pipe dreams and hefty credit card bills, and that the cultivator is dear old Mr. Wybrant and others of his ilk.

The only substances ever proven to regrow hair that are approved by the FDA (Federal Drug Administration) are Minoxydil, marketed as Rogaine and Finasteride, marketed as Propecia. Rogaine is available over the counter, and must be applied twice daily directly on the balding area. It has not been proven to grow hair in the receding temple area, which is usually the biggest concern of hair loss sufferers. The biggest problem is that once the treatment is stopped, any hair grown from the treatment will fall out. Those poor follicles have to keep dancing as fast as they can (even after the music has stopped).

There are many other topical treatments that are cosmetic, meaning that they temporarily improve the appearance of the hair. Gels and sprays are thickening agents which bond to the hair and make it appear thicker. Cover-up sprays color the scalp, giving the illusion of hair (kind of like the mirage of water in a hairless desert). None of these options are permanent. They can also be very messy to apply and don't often accommodate an active life style. They seem to work best for those hair loss sufferers out there who live in a comatose state.

Some turn to drugs for the answers. (What else is new?) The thought of just being able to swallow a pill and solve hair loss problems sounds like something too good to be true, doesn't it? The drug, Finasteride, marketed as Propecia, does seem to hold such promise. It is available only through a doctor's prescription. Propecia is mainly effective on the back of the head, or bald spot. Its best use, as ascertained in a recent study, seems to be in slowing down hair loss. Eighty-three percent of the men involved in the study maintained their hair count or grew more hair. Women cannot take this drug or even touch a broken tablet because of the danger of birth defects.

Hair systems or pieces, wigs and weaves are a temporary answer to a permanent problem. They are attached either to the scalp or existing hair by a variety of methods, including glue, tape, clips implanted in the scalp or "woven" into the hair. They can be useful for certain types of hair loss, but they are very limited. Many wearers of such cover-ups opt instead for more permanent and worry free answers to hair loss.

Hair transplantation is a surgical procedure that removes hair from the back and sides of the head and transplants it to balding or thinning areas. Because the transplanted follicles keep their original genetic instructions (from that summer camp I told you about earlier), they keep growing hair for a lifetime. Transplants are simple yet sophisticated, and a good result can only be achieved by the training and experience of the surgery team that performs the procedure. So choose carefully, should this be your decision.

The last option is to do nothing at all and accept your baldness as a part of the unique genetic structure that made the rest of you. This is easier said than done because hair loss is often the first sign of aging and has such a dramatic impact on one's appearance. It is a very brave choice to make and a heavy testament to self-esteem, confidence and inner peace. Consider how many young men one sees who shave their heads to achieve a virile look. (Yul Brynner did it among others.) It has a sex appeal all its own that seems to seep from a powerful sense of self-acceptance. For women this is a harder alternative because our looks are so integrated with our hair. I know that I, for one, would feel a great deal of anxiety about not covering it up. The answer to how to deal with the loss of hair must lie within each one of us. I may have my hair and you may have yours, but that's today. What about tomorrow and how about the day after that?

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Copyright 2002