Baldness: Causes and Cures

American men spend more than $1.3 billion a year fighting baldness, and hair transplants are one of the most common forms of cosmetic surgery in men.

We have invited New York Post and Newsweek.com columnist Gersh Kuntzman, author of Hair! Man's Historic Quest to End Baldness, to talk to us about the causes and cures of baldness.

Hair! Man's Historic Quest to End Baldness offers a clever, surprisingly comprehensive, albeit quirky take on baldness--what causes it, how it affects its sufferers, what is being done to prevent it, and why bald men are so woefully underrepresented in Congress.

Why did you choose to write a book on the history of baldness?

Why is there such a stigma attached to male baldness, and has that been true throughout history?

The reason why modern men are stigmatized by this is that study after study shows that women look at a bald guy and they see a guy who's older than he is, and once you see a guy who's older, your first impression is that he's less virile. This is what bald men feel, rightly or wrongly, and he subsequently shows lower self-image, and this becomes a self-fulfilling prophecy. We live in a vain culture and a youth-oriented culture. Just as it was for the ancient Romans, baldness was a scourge--sheer vanity.

What about "Bald is beautiful?" Didn't people like Telly Savales, Yul Brynner, Bruce Willis, and Michael Jordan make being bald sexy? Hasn't that changed now?

Michael Jordan was at the vanguard of the "Bald is beautiful" movement. But rather than allow himself to go bald, he said that he would shave his head and redefine what being bald means. The key is "taking back his baldness."

Bruce Willis is still stuck in the "Old Hollywood" mode. So are Telly Savales and Yul Brynner. Bald men can be quirky old men, cheesy, but never leading men. But flash forward, Bruce Willis, they let him be bald, in quirky roles in Unbreakable and 12 Monkeys, but when they want him to be a leading man--in The Kid, for example (a Disney movie)--they make him wear a toupee. So what kind of message is Hollywood sending?

What causes baldness? Is it hereditary?

There is a genetic component for baldness. In men who have the genetic predisposition, the scalp on the top of their head will gradually go bald over the years. There's also a chemical component. It doesn't come down over the women's side.

Why is baldness less prevalent in Asia?

Nobody knows that. They just have a different gene pool.

In your book you say the ancient Egyptians thought baldness could be cured by rubbing the head with hippopotamus fat, or a balm made of burnt domestic mice, horse teeth, bear grease, and deer marrow. I know they sound ridiculous, but did any of these ancient techniques work?

There's no record that they worked. None did. If they did, they'd still use them today. The only thing that worked was--the ancient Romans invented the "comb-over," but that's not an ideal solution.

Back to modern times, is there any cure for baldness?

That's the thing. There is no cure for baldness. The only way to ward off baldness is look at eunuchs and use your imagination. There's no silver bullet pill that will grow a Chia Pet on the top of a man's head. That's what bald men are looking for. Propecia was supposed to be that, but it doesn't grow back hair. Anything that's gone is gone for good. Any hair that is gone, there's no way to get that back.

What solutions do work?

Transpants. New versus old techniques. No more "plugs"--more natural looking. In a lot of ways, this is the "golden age" for bald men. Transplants used to be what we commonly refer to as plugs. Yes, the hair grew, but eventually, it would look like a Kansas cornfield. Now they don't use plugs any more. They take hairs from the back of your head and evenly plant them. So now they look really good. It's very expensive, and physically arduous, but it is something people are more satisfied with.

Do medications such as Propecia (finasteride) and Rogaine (minoxidil) work?

Both of them work for some men. Propecia works for more men, because it's a pill you take. Both drugs help you hold on to what you've got. They do work, they're safe, and can be effective for a lot of men, but not every man. Neither will help bring back what's gone, they'll only help you keep what you have.

Is it true there are no new drugs in the pipeline for baldness that look promising?

No!

How about cover-ups, such as Toppik?

That's an unbelievable product. They take sheep hair, they electrostatically charge it, and it creates a forest effect.

And "hair clubs"?

Everybody thinks because it's called a "hair club," you pay a cover, and hang out with bald men, and your hair grows back. But it's really a toupee parlor. They make a good product. Nothing to be ashamed of. That's their marketing strategy, and it's been working.

Toupees are better than ever. In the old days (20-30 years ago) in the era of Hair!, men wore rugs. They called it the headhugger. Men still buy it today, this is what they think they're supposed to look like. More men want a more natural look. The better toupees are made in Italy, but they are hard to get.

How about herbs and the like? Saw palmetto, yohimbe, zinc, and Chinese green tea?

Saw Palmetto is ostensibly the natural form of Propecia. It does work, and more bald men are learning about it. Thre are a lot of herbs that don't do anything. Other than Saw palmetto, the reliability of some of these herbal remedies has not been proven. Herbs can interfere with other medications, and patients forget to tell their doctors.

And what doesn't work? Snake oil?

Massages, shampoos, and hot pepper. If it sounds too good to be true, it probably is. A money-back guarantee is always a tip-off.

I know this is a "men's health" topic, but, briefly, what solutions are there to help female baldness?

Some do. Female pattern baldness is different from male pattern baldness. So Rogaine for women is quite effective. There is no Propecia for women, and because it's hormonal, women shouldn't use it. They should stay away from broken pills. But there are some transplants that work for women, too.
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