Once baldness was accepted by men but recently, actor James Nesbitt admitted to a hair transplant and reportedly celebrity chef Gordon Ramsay has also followed suit. Experts reveal what to do if you're follicly challenged and why hair loss is so distressing for both men and women.
By Gabrielle Fagan
There's one sure way to dent a man's ego and that's to point out that he's thinning on top.
Baldness is a fate which most males dread and celebrities, as well as many other males in our image-conscious times, are now apparently prepared to go to great lengths to avoid it.
Actor James Nesbitt, 45, recently spoke about the anguish of losing his hair saying: "It's horrible going bald. Anyone who says it isn't is lying."
He's reportedly had two transplants, using a sophisticated hair redistribution technique, and he says they've "changed my life."
Chef Gordon Ramsay, 44, has also reportedly had help, allegedly costing a hair-raising 30,000, in a bid to thicken his thinning pate.
"The effect on men of hair loss is totally underestimated," says Shami Thomas, from Transform, the largest cosmetic surgery group in the UK which last year saw a 45% rise in the number of enquiries about hair transplant surgery.
"There's so much attention paid to image and appearance these days, and that coupled with the recession and insecurity about employment means people feel under pressure to look their best and avoid showing one of the key signs of ageing especially if they are competing with younger colleagues."
Many of the company's clients seeking hair treatment, she says, are in jobs such as sales, marketing, hospitality and media where appearance is key.
Prices at Transform start from around 3,500, and a follicular unit redistribution transplant from 7,000.
Thomas says: "Men are now seeing hair surgery as a wise investment in themselves that may protect their future."
There are around 7.4 million bald men in Britain, and male pattern baldness - known medically as androgenetic alopecia - affects nearly all men by the time they are 60. It can have a hereditary link.
For some hair loss can begin in the early twenties, but in general, a large percentage will see their locks diminish by the time they are 40.
While many are philosophical and go for a shaven-headed look - characteristic of EastEnders character Phil Mitchell, played by actor Steve McFadden - others seek help using hair growth lotions, resort to a comb-over, or a toupee.
"Men may join in the laughter when people make comments like 'baldy' or 'slaphead' or comment on a 'comb-over' but often secretly inside they are hurting," says Thomas.
"Surgeons say that it's not uncommon for men to cry at a consultation and explain that they've worried about the problem for up to 20 years and finally plucked up the courage to face it and do something about it."
"But public awareness and popularity of cosmetic surgery in recent years mean we are now seeing many more younger men in their thirties prepared to come for treatment."
According to the latest statistics from the British Association of Aesthetic Plastic Surgeons (BAAPS), demand for surgery, including hair transplants, by men grew by 21% last year.
And the huge improvement in transplant techniques over recent years, as well as the publicity given to well-known figures who've had successful treatments, is leading to a boom in numbers seeking help over hair loss, says Marilyn Sherlock, chair of the Institute of Trichologists.
"About 20 years ago hair transplants used to look fairly horrendous. Surgeons then removed plugs from the back of the head where the hair is usually denser and repositioned them in the area where the hair had thinned," she explains.
"But if the blood supply failed the hair later fell out and there were scars so the effect was often very unnatural."
"Nowadays, modern transplant techniques, if performed by a good surgeon, can create a completely natural effect."
Generally, she says, surgeons opt for one of two methods. Either they remove a strip of hair from the back of the scalp and then dissect the strip in to single hairs and transplant them into the thinning area, or they opt for Follicular Unit Extraction (FUE) which is more complicated, time-consuming and therefore much more expensive.
With this method a surgeon removes a large number of individual hair follicles from the back of the head, where baldness is rare. In both methods the surgeon makes an incision in the thinning area and inserts individual hair follicles. FUE has the advantage of not leaving a line scar, and only leaves small spot scars.
Although Sherlock points out: "Not every man is suitable for a transplant. For instance, there's no point transplanting hair in the front if you are continuing to severely recede as you will just have a space in the middle of your head.
"A surgeon will need to know the family history of hair loss to try to chart the eventual potential loss. Also there needs to be a good growth of hair on the back of the head so hairs can be harvested from it and repositioned."
She advises a man who feels he is losing his hair to consult a registered trichologist, a specialist dealing with the health of the hair and scalp, who can identify the cause of hair loss and suit treatment to the individual.
Thinning may be as a result of ill health, medication, diet or stress which can affect hormones.
"The craze for crash dieting is becoming a big cause of hair loss, as nutrients vital for hair growth cannot be absorbed if there are dietary imbalances," says Sherlock.
Among the treatments a specialist may prescribe is Finasteride, sold as Propecia, that can block the enzyme that converts testosterone into dihydrotestosterone (DHT), which may have an adverse affect on the hair.
There are also a variety of preparations on the market, including Minoxidil, sold over the counter as Regaine, which claim to reduce hair loss, but users must continue with it to retain the improvement.
Other treatments include shampoos and conditioners which aim to add 'volume', camouflage sprays which attach fibres to the hair, while some men wear toupees.
"When men go bald it can create feelings similar to a grieving process, and some may believe hair loss is so significant that they will attribute any failures in work and relationships to their lack of it, says Mr Mir Malkani, a cosmetic surgeon based in London who annually carries out around 200 hair transplants on men.
"There's no doubt that improving hair, whether by transplant or other treatments, can transform someone's life as you see a marked difference in their self-esteem and improved confidence in the way they feel about their appearance," he says.
Men may not believe it, but women are actually generally are less worried about baldness than men realise, says psychotherapist Sally Stubbs, but she points out it's how men feel about it that can affect their relationships.
She produces therapeutic CDs on coping with hair loss and says: "Many men perceive it as a stark reminder of the ageing process and find it extremely difficult to deal with."
"I've had clients who've felt it diminished their feeling of 'maleness' and have suffered low mood leading to emotional withdrawal, insomnia and problems with their sex lives."
The effect of hair loss should be far more recognised and men should know they can get help."
What can you do to beat hair loss?
:: Diet boost
Hair is composed of keratin, which gives it its strength. Too little protein, red meat, fish, eggs, chicken, affects keratin levels and hair can become weaker and stop growing, says Philip Kingsley, consultant trichologist.
Eating those foods and having breakfast is key, as he points out it's the morning meal that is the most important of the day for boosting hair follicles.
:: Go nutty
A lack of dietary iron may also lead to hair loss, as levels of ferritin in your body may drop and disrupt the hair growth cycle and increase hair shedding, says Kingsley.
He advises eating foods rich in iron, such as red meat, dark green vegetables, nuts and dried fruits.
:: Stay cool
An excess of male hormones - testosterone and dihydrotesterone (DHT) - can have an adverse effect on some parts of the hair follicle, points out Kingsley.
"They can cause the hair to become thinner. When men are under stress, their body produces more male hormones and so tend to lose more hair," he says.
:: Stub it out
A recent report from the medical journal Archives of Dermatology suggests that smoking may be linked to damaged blood supply to the hair follicle.
:: Information: Transform: 0800 655 6406/www.transforminglives.co.uk; British Association of Aesthetic Plastic Surgeons: www.baaps.org.uk; Institute of Trichologists: www.trichologists.co.uk; Mr Mir Malkani: www.kensingtoncosmeticclinics.com; Philip Kingsley: www.philipkingsley.com.
Tried & tested
It's never too early to start thinking about that bikini body - and that means addressing those unsightly stretch marks.
Kate Whiting tested a new laser treatment that claims to reduce the appearance of stretch marks by up to 75%.
What is it?
The Lux1540 fractional laser treatment is offered exclusively by The Harley Medical Group.
As well as zapping stretch marks, it can also treat surgical scars, acne scars and dark skin patches (melasma). The laser works by inducing a natural healing response in the skin, which stimulates the growth of new tissue.
Since launching in May, the treatment has become the Group's second most popular non-surgical procedure.
What is it like?
Although I've never had children, my weight has fluctuated in the past and I'm one of the 23 million women in the UK with stretch marks.
While they initially emerged as red, mine have now mellowed into the silvery colour so many women have come to know and hate.
To add to my woes, I've also had keyhole surgery and have two 50p-sized scars on my abdomen, so I jumped at the chance to minimise those as well.
I opted to have the stretch marks on only one hip treated, so at the end of the course I could compare the treated side with the untreated side.
The Group recommends having at least four laser treatments, each a month apart, and I opted for four. Each session lasted around 20 minutes and it feels as though a tiny hot pin is pricking your skin which is slightly painful but quite bearable.
Afterwards, a specialist nurse places ice packs on the areas to help cool them. Initially, I was worried that my skin swelled into red blotches afterwards but within a few weeks these always disappeared.
When I'd completed the course I was delighted that the silvery stretch marks were definitely less obvious - in marked contrast with the untreated side.
But I was disappointed that the treatment didn't seem to have any effect on my scars. Maybe that's because they are long-standing, quite deep and dark coloured. For me this wasn't the miracle cure I'd hoped for but I would return for further treatment for the stretch marks.
:: Information: The Lux1540 fractional laser treatment is offered exclusively by The Harley Medical Group, which has 30 clinics throughout the UK and Ireland. The cost of each treatment is from 250, depending on the size of the area being treated. For more information visit www.harleymedical.co.uk.