Never mind the follicles: the bald facts of hair loss

The Lib Dem MP Mark Oaten blames baldness for his embarrassing sexual shenanigans - but does losing your hair really need to trigger a mid-life crisis? The hirsute Jonathan Brown reports

Elisha didn't much like attention being drawn to the fact that he was follically challenged. During his celebrated journey to Bethel, the prophet found himself accosted by a group of youths from the local town who harangued him with the words: "Go on up, you bald head." His - and God's - response was firm. Elisha cursed the youths and two bears emerged from the woods, ripping 42 of the youngsters apart with their claws. It was clearly a sensitive subject even then.

Mark Oaten, the former Liberal Democrat leadership contender and Home Affairs spokesman, is also rather touchy about his appearance it seems. Breaking his four-month silence over the affair with a rent boy that cost him his front bench job and shattered his life, Mr Oaten, 40, says he believes it was the sudden onset of baldness that drove him into the arms of a male prostitute.

In a remarkably candid article, the Lib Dem MP describes how overwork and the pressure of living in the Westminster village coincided with "something of a mid-life crisis". Losing his hair in his late thirties had "knocked me for six" he says. "I started to look noticeably older."

He found that his thinning locks were attracting more attention than the important messages he was trying to convey about the Liberal Democrat policy on law and order. Television appearances would result in a "barrage of emails" noting his lack of hair. "I became more and more obsessed by its disappearance."

Clearly, other factors were involved too, and Mr Oaten is working these through privately with his psychiatrist. But for him, the bald truth was that every time he looked in the mirror or saw himself on television, his receding hairline reminded him that his youth was over.

It may not be as simple as that however, says Phillip Hodson, a fellow of the British Association for Counselling and Psychotherapy, who started losing his hair at the age of 31. While most men accept, and some even celebrate, their baldness, helped by the fashion for closely cropped hair, others are badly affected.

Mr Hodson has encountered many patients suffering from psychological symptoms. "In the most extreme cases, the complex about their lack of hair can be a version of obsessive compulsive disorder - almost to the point of body dysmorphic disorder. They don't just see an absence of hair but of a much greater loss. There is something often severely damaged about these people," he says.

Professional help will often mean talking through the deeper issues underpinning the fears of baldness - often a long and painful process. "What it can be is a symptom of fundamental shyness and insecurity," Mr Hodson says. Pressures to look good, particularly for a politician, are ever more acute in the media age.

Baldness might never have been an issue for Sir Winston Churchill but the political fortunes of bald Tory leaders William Hague and Iain Duncan Smith probably suffered as a result of their appearance compared with that of Tony Blair.

But as we suffer today, so too did the ancients. The Nazarite Samson's strength resided in his hair and in his pact with God not to shave or cut it. The intervention of the Philistines and a defoliation session courtesy of the seductress Delilah led to his capture blinding and imprisonment.

Elsewhere in the Old Testament, God threatens to hand out baldness to the enemies of Israel with a startling regularity even, according to Revelations, as a final humiliation to evil doers at the end of the world. The association with divine punishment goes some way towards explaining the stigma attached to baldness. Many great men have wrestled with it. At its heart, it is argued, baldness can be perceived as an outward sign of waning virility.

The mighty Hannibal, for all the pain he inflicted on the Roman legions, is said to have endured baldness with a surprising bad grace. Julius Caesar, whose name, ironically, translates as "abundant hair" was as bald as the proverbial coot (which - apart from the white plate above its beak - is actually covered in feathers). Caesar used a simple yet effective ruse to cover his baldness; he insisted on wearing elaborate ceremonial laurel wreaths. It was a technique adopted by Sir Elton John, who at the height of his insecurity over his appearance, wore outlandish headgear on-stage and a hat everywhere else.

A more modest, though often frankly unsuccessful, option has been the use of the "comb over" - a fashion statement that reached its apotheosis on the head of Manchester United and England footballer Sir Bobby Charlton. For others, the only course of action has been the dodgy "syrup" - a wig.

As sufferers down the centuries have learnt to their expense, the one person sure to be attracted to baldness is someone with a supposed cure for it. Until recent decades lotions, potions and unctions fitted into the category of snake oil - or worse.

Caesar eschewed the rancid hippo fat favoured by the Egyptians, preferring to anoint his gleaming crown with a preparation of powdered horse teeth and deer marrow cooked for him by his mistress, Cleopatra.

Other civilisations developed their own solutions. The Chinese used plants, the Renaissance Italians favoured cow saliva while in India, the front-line treatment was meditation and headstands. The advent of new technologies, saw all manner of electric buzzers, suction pads and massagers deployed to the task. The one thing they had in common was the failure to re-seed a single balding pate.

It was Hippocrates who gained the first real insight into baldness, yet the solution it suggested, even for those obsessed by the problem, was just too drastic. Eunuchs in the Persian army, he noted, never lost their hair.

The cause of pattern baldness continues to be debated. Sufferers tend to have an excess of "free" testosterone in their bodies and higher levels of androgens including the hair growth stimulator dihydrotestosterone. Genetics play a decisive role, although baldness is not passed on just from the maternal grandfather - that is one of many myths surrounding the subject.

New research has also focused on the role which fat-rich diets, lack of exercise and stress play in causing pattern baldness. Scientists seeking to understand its cause have focussed their attention on Japan, where changes in lifestyle and particularly diet since the end of the Second World War have caused something of an explosion in the condition.

It is estimated that more than two thirds of adult men will suffer from male pattern baldness or androgenic alopecia - a condition characterised by a progressive thinning of the hair as it recedes from the sides and sometimes on the top.

The effect is produced by a gradual narrowing of the hair follicles producing the distinctive "peach fuzz' appearance. It can start at any time from the onset of puberty and is measured on the eight point Hamilton-Norwood scale. Female pattern baldness, caused by a lack of estrogen, is measured on the I-III Ludwig scale.

Considering its extent and the psychological impact baldness can have on both men and women - it is one of the most unpleasant and distressing side effects for cancer patients undergoing chemotherapy - it is little surprise that treating it has snowballed into a vast global industry. In the US alone, the estimated 35 million baldies spend $1.5bn a year on hair restoration products, drugs and transplant surgery.

Hair transplants have been tried with varying levels of success for more than 50 years. But as well as the much derided "bottle-brush" effect caused by transplanting hair from the side or the back of the head, the technology is limited by the sheer quantity of hair available elsewhere on the body.

The quest to find the secret ingredient that will cause hair or "dermal papilla" cells to replicate in a laboratory has become a Holy Grail among researchers. Whoever succeeds in finding an effective treatment can be assured that it will make them rich.

Perhaps the biggest breakthrough to date came in 1990 when Colin Jahoda, a British researcher at the University of Durham, took follicle cells from his head and cultured them. He later implanted them between pale hair on his wife's arm where a thick dark hair with male DNA promptly grew.

A similar experiment also worked in mice. But what promised to herald a brave new era where a cure for baldness was grown in the petri-dishes of laboratories has failed to materialise and scientists appear to be losing hope.

One area that has borne fruit is in the development of drug treatments. Minoxidil, marketed under the brand name Regaine, generated feverish excitement when it first appeared on the market. Discovered by accident, it was found to encourage existing hairs to grow stronger and thicker. The drawback is that it only works in 1 per cent of baldness sufferers.

There are those who subscribe to a different perspective. For them, a shine dome is a proud badge of maturity - an evolutionary characteristic that identifies bald men as better, more reliable sexual mates who have left behind the fecklessness of youth.

Maybe Mr Oaten should be reassured by the words of the American aphorism king, Logan Pearsall Smith, who remarked: "There is more felicity on the far side of baldness than young men can possibly imagine."

Mark Oaten: 'I really felt I was losing my youth'

'For most of my life, I have never had any doubts about my sexuality. But I have now come to believe that a person's sexuality is not such a black or white issue.'

'I don't think I would ever have had reason to reconsider my sexuality had it not been for a combination of factors and events at a difficult period in my life.'

'I had become a passenger to my own career, swept along by the enthusiasm of others and unable to control where I was heading.'

'I doubt that, on its own, my dissatisfaction with politics would have prompted me to act as I did, but it coincided with something of a mid-life crisis. I was turning 40 and I really felt that I was losing my youth. The problem was undoubtedly compounded by my dramatic loss of hair. This really knocked me for six. I started to look noticeably older.'

'Any television appearance would result in a barrage of e-mails, not about the issues but about my lack of hair. It's perhaps not surprising that I became more and more obsessed by its disappearance. For me it was a public sign that my youth had ended.'

'Deceitfulness is the norm as each day we try to withhold information from the press, from our colleagues and from our political opponents.'

Sure signs of a mid-life crisis

Career change

Packing in the job for a mid-life gap year. Balding backpackers travel the world while others switch careers for that long-dreamed about life as a football coach.

Sports cars

Remortgaging the family house to pay for a shiny new sports car or Harley-Davidson motorbike.

Image change

Trendy clothes, a new haircut (if he has any left), ear piercings, body waxing, tattoos and skincare regimes. Black leather jackets are a popular choice.

Health kick

Diets, gym membership and a desire to run the London Marathon.

Musical hobbies

Learning to play the guitar, joining a band and listening to hip-hop in an attempt to be cool. Comic Johnny Vegas admitted that taking up the cello was "symptomatic" of his mid-life crisis. Others buy an iPod.

Weekends for the boys

Nightclubs, surfing and car rallying.

Rekindling past romances or friendships

Whatever happened to the girl he first kissed, or that gorgeous blonde at university, or the mate who always got him into trouble at school? Internet sites make it easier than ever to track down people from the past.

The meaning of life

Self-help books, meditation classes and spiritual journeys in a quest to discover the soul.