You are not Bald - Just Comb-free

Dr. Jose Pujalte Jr

"Time to turn back and descend the stair, with a bald spot in the middle of my hair... Do I dare, disturb the universe?"   T.S. Eliot (1888-1965)

Anglo-American poet

"The Love Song of J. Alfred Prufrock"

I WAS surprised to find a small book on "politically correct" words a few weeks back.

It can be amusing to those who say it like it is. Filipinos would think twice before calling a woman "ugly."

The woman is "simple and uncomplicated." And instead of saying someone is short, he is referred to as "vertically-challenged." That middle-aged man isn’t bald! He is "comb-free."

Well, it isn’t funny.

If women fret about sagging skin and breasts, eye bags, and saddle bags and (the list is endless), men worry only about two things, health-wise: Erectile dysfunction and baldness. With Viagra®, Levitra®, and Cialis® flooding the market, there’s no shortage of erections, I’m sure. But baldness?

It’s been a puzzlement since Caesar covered his pate with laurel leaves and orated before a captive public.

Hair basics. The average scalp has about 10,000 hairs in varying rates of growth. Approximately 100 strands are lost every day. So there really is no need to panic when you see plaits on your pillow in the morning, or in the bathroom sink after some vigorous brushing.

An individual hair can live from 4 to 6 years, growing about half an inch a month, to the delight of your favorite barber or stylist.

Now each piece of hair is rooted in a cavity of the scalp called the follicle. In balding men, it is this follicle that shrinks. Soon enough, the hair that grows out of it becomes shorter and finer. In time, no hair grows at all.

Male-pattern baldness. We all know of beer bellies – what I’d call male-pattern fatness because this is genetically determined to deposit in the abdomen (women tend to keep fat around the hips and thighs).

Male-pattern baldness is also inherited (take a look at Grandfather and Father) and is related to the hormone testosterone. It seems that those who have no testosterone also have no problem with hair loss.

A receding hair line marks the start of hair loss followed by a thinning spot at the crown.

Eventually, a "horseshoe" ring of hair is what’s left if any hair is left at all. About 25% of men begin to bald by age 30 and 2/3rds are bald or balding by age 60.

Atypical hair loss. Women may also lose hair, especially after menopause. However, the hair line remains intact and hair thins so that you can see the white of the scalp. Also, not all hair loss is due to heredity. There are some cases that warrant a deeper investigation. Please see a doctor if hair loss is:

* in patches (alopecia areata) including hair loss in the eyebrows – could indicate an immune disorder

* due to hair-pulling (some bite their nails, scratch themselves until bleeding) – all nervous habits that require attention from a professional due to infection like ringworm of the scalp (tinea capitis)

* due to burns, cancer medication or radiation therapy

* due to tumors of the ovary or adrenal glands.

* occurring at a young age – teens and twenties

What to do? If skin changes are noted together with the hair loss, a biopsy may be taken. Hair may even be examined microscopically. For those losing hair because of chemotherapy or radiation therapy, it usually grows back after the toxic treatments. Now for hair loss because of heredity, age or hormones, there are two effective and proven medications.

The first is minoxidil a topical medication (applied on the scalp) for at least six months before any results can be seen.

Minoxidil can be used by both men and women. The second drug is finasteride, taken orally and only for men. The downside of finasteride is a decreased sex drive (oh well, you can’t have it all – lose your erection but get your hair back).

Finally, the old reliables – toupees, hair weaves, and all sorts of operations to transplant hair, plug by plug to your own deforested areas. Still, there are some who taunt their fate by shaving all hair, once and for all.

This seems to me the most enlightened of solutions but then again, I’m not losing much hair (yet). My Lolo had hair so thick you could wipe your hands off it after washing.

Balding is in the end a perception issue. Most wise men wouldn’t look so wise if hair flowed like Samson’s – and look what happened to him. There are indeed more important things to worry about.

Losing sleep over lost hair just isn’t worth it. Indeed, one of the gifts of growing older is a return to nurturing an immovable pith. If you haven’t taken the time to cultivate a center, then it’s probably best to stay superficial and spend all your money on hair and skin