Stay Cool-Headed
There’s no “wrong way” to go bald, but an arsenal of smart tools and helpful unguents can make the transition smoother. Here are some of Harry James’s must-haves
long been marketed as Propecia, a tablet, and Regaine, a lotion.
These treatments have been proven to arrest hair loss and increase regrowth, but are not without flaws. Finasteride was originally developed to treat prostate enlargement, and hair growth was noticed as a side effect. It functions by reducing the action of dihydrotestosterone (DHT), a sub-product of testosterone, which causes hair follicles to shrink. Minoxidil was developed as a treatment for high blood pressure but was also discovered to make hair follicles wider and deeper. Both have been available as generic medicines for some time.
According to Dr David Fenton, a consultant dermatologist and spokesperson for the British Association of Dermatologists, “The hair follicles on the top, front and crown of the scalp are sensitive to circulating androgens. Their presence, in normal levels, can, in some people, be enough for those follicles to shrink and for the hairs to become finer and shorter, with more space in between. You don’t need any excess of the hormone, and you either inherit the tendency or you don’t.”
While brands’ websites are naturally keen to showcase their success stories, these treatments don’t work for everyone. “In 30-40% of people, minoxidil lotion doesn’t work; in 20% who take finasteride, it doesn’t work,” says Dr Fenton. “Finasteride is more efficient. It can put the brakes on, so you still thin, just more slowly, or halt the progression completely, or even reverse it to some degree. But you’ve got to maintain the treatments. If you stop the therapy, you start to lose the efficacy.”
Unwelcome Effects
There are also possible side effects to finasteride. “Some people get reduced libido, erectile dysfunction, breast sensitivity and – rarely – breast cancer,” says Dr Fenton. With this in mind, he cautions against online purchases: “I would always encourage people to go to their own GP to get the right advice and the official product.”
There is an irony in the fact that these seemingly new treatments have been available for some years, without the slick packaging and clever marketing, and a further irony in that many brands combine finasteride with treatments for one of its potential side effects: erectile dysfunction. But problems caused by those side effects are very real. The last few years have seen a number of men come forward to report concerning testimonies on issues occurring both during and after finasteride treatments, and there is a growing momentum to have post-finasteride syndrome classified as an illness.
The Post-Finasteride Research Association in Berlin was founded by Simon Breidert, a 36-year-old physician who had been using it for two years when he noticed dry skin and insomnia. He stopped, only for more symptoms to appear.
“I tried to withdraw and that’s when things got crazy,” he says. “The insomnia got worse. I was sleeping one hour a night for six weeks, then not sleeping at all. I felt brain-fogged and had to stop driving as it was dangerous. I had gastrointestinal problems, and my sex life got really bad. I couldn’t hold an erection on Viagra. I didn’t enjoy sex. I always liked proximity, closeness and cuddling, and that was gone. I didn’t feel anything or miss anyone.”
Over time, his brain fog lifted and his sleep improved. “I can work, think and be productive,” says Breidert. “But my quality of life is lower.” According to him, he isn’t alone in his experiences. “PFS affects maybe one in 1,000 men,” he estimates. “But when millions of men are taking finasteride, it amounts to a lot of people.”
Breidert campaigns to raise awareness of PFS, with the ultimate aim of having it classified as an illness.
His concerns are shared by Dr Fenton. “If someone has a background of depression and anxiety, maybe they shouldn’t be taking this drug,” he says.
“If I opened up about it, I’d be showing that I was weak”
Bald Decisions
James has his own views on the way that anti-hair loss drugs are marketed. Brands often play on insecurities to shift units, and in a Bald Café vlog entitled “Are Balding Men Being Shamed to Sell Hair Products?” he deconstructs the language and content of their communications.
“Guys feel like, ‘If I’m not using that stuff then I’m choosing to lose my hair,’” he says. “You’re self-conscious and desperate, and you’ve got companies bombarding you with things like: ‘I can sort this out for you!’ But if you start using this stuff, you have to use it for ever. They present it as a holy grail, but that’s not the reality.” There is a strong case to argue that balding isn’t so much a physiological problem as a psychological one, bound up within the nexus of masculine insecurities relating to appearance, strength, youth and vitality. The male ego can be a fragile thing, and balding impinges savagely on confidence, perhaps the most prized masculine quality of all. But confidence can be rebuilt through exposure to experiences that provoke fear: in cognitive behavioural therapy (CBT) “flooding” is the term used for confronting that which terrifies us, from spiders to heights and – yep – baldness, in a bid to overcome our fear. This is exactly what James, Bakht and others on the channel have done.
Pushing through fear to build unshakable confidence is difficult at any stage in life, but particularly so when you’re a teenager, already burdened by the insecurities that come with that territory.
Ben Spowart, now 22, used to coiffure his hair into a Justin Bieber-style sweep, and turn up to work half an hour early to make sure it stayed in place. He was 15 when he noticed his hairline was receding; by 18, the anxiety of his encroaching baldness was exacting a heavy toll on his mental health.
“My biggest fear was the wind,” he says, “because I couldn’t control the fact that my fringe would move while I’m out and this would draw people’s attention to my receding hairline.” Playing football, his mind was on his hair, not the game. The pressure he put on himself to hide his hair loss was, he says “exhausting”.
But he kept quiet. “It would be the end of the world if I opened up about it, because I’d be showing that I was weak.”
On what he now calls Judgement
Day, Spowart went for a run without a hat for the first time. After that, things changed. “I shaved my head in January,” he says. “It’s down to a buzzcut. It’s a style I’m feeling confident about. I wish I had focused on my mental health and happiness sooner rather than wasting my energy on the opinion of others.”
The way James sees it, braving the shave is a way of owning what you don’t have control over. “It’s happening to you. You didn’t ask for it,” he reflects. “I had an image of how ugly I was going to look. You don’t think, ‘Will anyone find me attractive?’ You think, ‘No one is going to find me attractive.’ But if you feel you look good, then you look good.”
To prove the point even more audaciously, James recently grew out his balding hair, facing yet another fear, and arriving at a tufty look that might remind you of Larry David.
“I thought, ‘I have to be fully at ease,’ and to do that I need to be in that position I was afraid of – looking like a guy who is losing his hair,” James recalls. “It took a couple of attempts. I got to two weeks and it felt untidy. I grew it out again and gave myself an actual haircut, a bit of a fade, and there it was. No one was bothered, and that gave me that final piece of closure. I just felt comfortable.”