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April 2004

The bald truth about hair loss


By Dr Thomas Stuttaford

British men are European leaders when it comes to the early loss of hair - it's time to plant a little optimism.

Any description of Lucian Freud is likely to include the phrase “Britain’s greatest living artist” and to contain stories illustrating the idiosyncrasies of his lifestyle.

As an addendum to Freud’s latest exhibition at the Wallace Collection in Marylebone, the National Portrait Gallery is staging an exhibition of photographs by David Dawson, a gifted painter in his own right.

His photos capture life within Freud’s studio over the past four years — Dawson continues where the late Bruce Bernard, the brother of the late writer Jeffrey, left off.

Dawson perhaps knows Freud better than Bernard because he is not only his assistant but also a painter, as well as a confidant and friend, whose day is structured around Freud and his painting.

Dawson grew up in rural Wales, helping out as a part-time shepherd before taking an MA at the Royal College of Art. He has worked with Freud for 12 years. His photographs of life in the latter’s studio are supplemented by many others, including dogs.

Freud’s nude paintings of Dawson reveal one of the more obvious effects of either being richly endowed with high levels of dihydrotestosterone, or having tissues unusually sensitive to its action. This characteristic has already excited comment in the gossip columns.

Most blessings have a downside, and that associated with high testosterone levels, or sensitivity, is a tendency to show early signs of malepattern baldness. In common with 6.5 million men in the UK, Dawson, who is now in early middle age, has a receding hairline. One in two British men experiences excessive hair loss before the age of 50.

A recent survey of 1,500 men in five European countries revealed that British men were the worst hit by early loss of scalp hair. The Germans are almost as severely affected — they head the balding league — but there is a difference: nine out of ten British men accept a receding hairline in their early forties as an act of God, or a downside of their masculinity. They generally do no more to try to disguise it than by having their hair cut very short, whereas the Germans try to do something about it. They have the wiser approach. There is evidence, even without delving into William Hague’s political history, that men’s ability is too often judged by the amount of hair they have retained.

We should realise that in many cases something can now be done to alleviate baldness. There are two treatments that may work. Propecia (finasteride), a 5 alpha reductase inhibitor, is taken once a day orally. Finasteride in larger doses is marketed as Proscar, which is invaluable in treating benignly enlarged prostates.

The alternative to Proscar is Regaine (minoxidil), which is usually applied to the scalp twice daily in a 5 per cent solution. Either of these treatments can be effective, but they need to be used regularly. The life history of a hair determines that the beneficial effect is not instantaneous and treatment must be continued for between four and six months before hope is abandoned.