Men (and women) face up to hair loss Ever since Samson lost his hair and his strength along with it, men have been insecure about baldness. Kim Dismont-Robinson reports on how many men are coming to terms with it -- and for those who are not, some treatments for getting it back.

This article may be moot, because there are no balding men in Bermuda.

At least you'd think so, since most men seemed outraged when they were approached to talk to them about hair loss: "What are you asking me for?. .. I shave my head as a hairstyle, I'm not balding... I've got a high forehead... I'm just a little thin on top... hey, buzz off, okay?'' Hair loss is such a sensitive issue for many men -- and a few women -- that even close friends with thinning locks were reluctant to discuss their feelings on the matter.

What's the frustrating part about genetic hair loss is there is often very little that can be done about it.

But many folks with thinning hair will try various methods, from the creatively sublime to the ridiculous, to mask bald spots.

Balding people with dark hair are often particularly sensitive, since the contrast between their hair and scalp colour can make hair loss seem even more dramatic. It's sometimes combated by dyeing hair a lighter colour or even using eye shadow on the scalp.

Wigs and toupees sometimes help the wearer retain much of their self-esteem, which often suffers a blow at the onset of balding -- but toupees and wigs can create as much anxiety as the original baldness if they don't look realistic.

"Comb-overs'' and "comb-backs'', where hair is grown particularly long on one part of the head and then swept over the bald area, tend to be more popular among the older set.

More and more often among the younger generation, balding men seem just as comfortable shaving their entire head and sport a shining pate.

Other people like Michael Jordan, singer Sinead O'Connor, male supermodel Tyson Beckford and Jean Luc Picard from Star Trek have gone a long way in helping baldy hair cuts become acceptable as fashionably sexy.

Many men seem to connect the appearance of a full mane of hair with strength and virility -- and one of the oldest stories making such a connection comes straight from the Bible in the tale of Sampson and Delilah.

After much searching, The Royal Gazette found two fellows comfortable enough with their heads to talk about being "follically challenged''.

Travis Gilbert Jr. is a 29-year-old Bermudian who first noticed his thinning hair when he was 26 years old.

"At first, I didn't really have a problem with it because I felt like it wasn't a big deal,'' said Mr. Gilbert.

"That position was seriously challenged when I realised that this was for real,'' he chuckled. "But I think it offered me an opportunity to grow and to really determine whether or not I had been hypnotised by traditional standards of beauty.

"There was a point where I felt a little pinch which made me think, `to what extent does it matter?' -- but now I feel it's an issue that's been resolved.

"I did decide to cut my hair really low because it reached a point when it was no longer an afro, it was more like a half-fro -- so I decided to submit to Mother Nature.

"When I came back from school, it was a relatively dramatic change for people who knew me, and the reactions were varied -- some people teased me, and others weren't sure if they'd hurt my feelings if they mentioned it. But often it does represent a conversation piece.

"But when I see people like Michael Jordan on TV, it is comforting to realise that others lead normal lives while suffering from the same affliction,'' he chuckled.

"Thomas'', who declined to give his real name, is a 28-year-old man who first noticed his receding hairline in his late teens.

"I didn't pay it much mind at first because my hair has always been kinda fine,'' he said.

"But I really began to notice when I tried to lock my hair, and I noticed that the base of the dredlock was thinner than the end.

"There was no panic, and I never had any self-esteem issues attached to it.

My attitude was, `oh well, my hair's going'.

"I guess there was a tinge of regret that I didn't have any choice in the matter, but it was never a major issue for me -- just something that had to be accepted.

"The hardest part was dealing with people who felt they had to point it out to me, and then apologised for it as if it were a secret I was trying to hide.'' Thomas continued to wear his box haircut for a couple of years, then shaved his head for the first time when he was about 23 -- which is how he still wears it today.

"The box cut wasn't working because my hair was going back, so I decided to shave it because it would look better -- but it wasn't about masking the fact that I was going bald,'' said Thomas.

"I shave my head once a week, and if I was trying to mask it, I'd shave more often than that. I either use shears or I use a Gillette -- the best a man can get.

"I'd never get a transplant, though -- they're too expensive and it's not worth bothering. You've just got to let go, and the women really like it.'' Can bald be beautiful? Baldness, or "alopecia'' can stem from a number of different sources, but generally falls into two categories: scarring/permanent hair loss, or non-scarring/temporary hair loss.

And Alexander Romeo at the Point Finger Road Medical Centre, Bermuda's only full-time dermatologist, said there are a number of factors that can contribute to hair loss -- from genetics to stress.

Dr. Romeo said the most common cause of hair loss is male pattern baldness, which is "genetically programmed, like a clock ticking''.

"The follicles are no longer stimulated because a particular hormone is blocked -- but the follicles are still there, and you can see fine (peach fuzz) with a microscope,'' he said.

Emotional factors, such as the death of a family member or stress can cause temporary hair loss -- and although it's not unusual for the hair to grow back, it may require medical assistance.

Crash diets and undernourishment can cause baldness, so hair loss is often a side effect experienced by bulimics and anorexics.

Dr. Romeo said the most common reason for hair loss among his patients are the result of hair treatment and medicinal chemicals.

Medications can cause hair loss, specifically those that help control blood pressure as well as those that help stabilise patients suffering from mental diseases such as schizophrenia and manic depression.

Hair treatments such as perms, dyes or relaxers can also cause baldness. And the use of hot combs over long periods of time cause hair loss so commonly that the condition is identified as "hot comb alopecia''.

Dr. Romeo noted that hair loss other than male pattern balding should be checked out, since they can often point to potentially serious underlying conditions.

Thyroid diseases, diabetes, syphilis and lupus can all result in permanent hair loss. Cancerous tumours in other parts of the body can sometimes produce baldness as a symptom that the cancer is creating a hormone imbalance or that the disease has spread.

And Dr. Romeo said the reason why chemotherapy patients often experience hair loss is because the treatment is meant to suppress rapidly dividing cancer cells -- and hair is made of one of the most rapidly dividing types of cells.

And although far less common than male pattern baldness, Dr. Romeo noted that women can be genetically disposed toward hair loss as well.

"Men say they don't want to go bald, and when it happens they're concerned and upset. But more so for women -- it's a very emotional topic because they don't think it should happen to them,'' said Dr. Romeo.

"Society puts a lot of emphasis on women's appearance, and women are more tolerant of males becoming bald than men are of their women being bald -- so it's a cultural expectation, too.'' Despite the number of herbal remedies, lotions, pills and powders available at stores and on the Internet, Dr. Romeo emphasised that only two methods of treating pattern baldness were approved by the US Food and Drug Association -- Rogaine and Propecia. And he noted that the products are more effective on younger patients.

Rogaine is a relatively well-known lotion that is rubbed onto the scalp to promote hair growth.

Although men and women can both use Rogaine, it's usually more effective on men, and even with that only about 15 percent of users have good results.

Plus, Rogaine has to be used indefinitely to sustain any benefits it might have.

Propecia is a relatively new pill currently out on the market. It was initially used to treat men with prostate cancer, and hair growth was noted as a side effect.

Dr. Romeo said Propecia is effective on about 65 percent of men who take it -- but like Rogaine, it must be taken indefinitely to maintain growth.

Propecia has not been as successful as hoped in the US for two reasons: it can cause temporary loss of sex drive in about two percent of men, and women should not even touch it since it may cause birth defects see article below.

And Dr. Romeo said although you'll have to go abroad if you want a hair transplant operation, they are very effective.

Be like Mike: Michael Jordan, far right, has gone a long way to making baldness cool with the shaved head look. Other famous baldies, from left: Michael McCary of Boyz II Men, US Federal Reserve Board chairman Alan Greenspan, tennis star Andre Agassi, Patrick Stewart (Star Trek's Jean Luc Picard) and movie star Jack Nicholson, who has succeeded in an industry obsessed with looks and youth.