It was the different lighting in the hotel room that did it. Adam West was dressing for his brother’s wedding and went over to the mirror for a final check. He couldn’t believe what he saw: the thick blond mop that he had always taken for granted was thinning. At home he had never really looked at it; he just used to tug a brush through it as he rushed out.

But now he began to panic,- he was only twenty-two. This had to be stopped. Unfortunately for west, what he was seeing was the beginning of classic male-pattern balding, which is genetically determined and which cannot be halted.

The exact process that shuts down the hair follicles in genetic balding is not fully understood, but it is known that the hormone testosterone plays an important part. Men with this inheritance basically have four options: they can do nothing,-they can have surgery using one of the new techniques,- they can get artificial hair,- or, if they are very lucky, they may respond to the first drug for baldness now available in Australia.

At the time, West knew none of this. He just felt his panic growing. Thinking about it made him anxious and unhappy, and over the next few years his image of himself began to change. As his hair thinned he felt progressively less attractive. Each morning he would check his pillow, his brush and even the shower drain for evidence of lost hair.

By twenty-six, West was shiny bald on top. Around the edges his hair was still thick but this did not ease the discomfort of being repeatedly called ‘chrome dome’ or ‘billiard ball’ by well-meaning mates. In fact, their gibes dovetailed with his own bad feelings and his anxiety was compounded.

‘Personally, I felt people began to treat me differently when I started to lose hair,’ West said. ‘I felt less included, less listened to, less important and less attractive to women.

For years, West did the rounds of baldness clinics but found himself continually deciding to endure his discomfort rather than place his head in the hands of a person he could not trust. His caution was well justified. In Australia the hair replacement industry has an annual turnover of $50 million to $60 million and there are many unscrupulous practitioners ready to exploit balding men’s vulnerability. They talk nonsense about poor circulation of the scalp, oil blocking hair follicles and embedded dandruff and then make certain they get huge fees up front.

Balding men can be easy prey. For a few thousand dollars many will buy the hope of restored youthfulness and sexual attractiveness. But hope is not enough. A special report on balding in Choice magazine in 1991 concluded that the only real options were surgery or some kind of artificial hair.

While surgery is not a ‘cure’, it does offer a practical way for balding men to have their own hair relocated. The old transplant method, made famous by Elton John, has been superseded. This involved transplanting plugs of scalp containing about fifteen hair follicles. The new hair then had a tufted toothbrush look. Now, with minigrafting, two or three follicles can be relocated at a time.

Another surgical procedure is ‘flap rotation’ where a strip of hair is cut from one side of the head. It remains attached at one end ‘for blood circulation’ and is rotated to form a new hairline. The edges where the strip was removed are sewn together.

West opted for another technique called ‘scalp reduction’. With this, a narrow strip of bald scalp is cut out and the hair-bearing sides and back of the scalp are stretched upward and forward to close the gap. After about five operations over eighteen months, the bald patch is usually gone and the hairline can then be fixed using flap rotation and mini- or micro-grafts. Surgery costs about $1500 plus (not covered by Medicare) and takes about two hours under local anaesthetic.

Scalp reduction has been made popular in Australia by Dr Mario Marzola. He has refined the operation which was first performed in California in 1979. Instead of cutting down the middle of the bald scalp, which is easy and comfortable for the surgeon, he adjusts the surgery to the pattern of baldness.

The disadvantages of scalp reduction over micrografting are that there may be some intermittent scarring until the procedures are complete. Also, there may be some distortion in the direction of hair growth. The hair is permanent, grows normally and requires no maintenance apart from usual hairdressing.

The Choice report said not everyone was suitable for hair transplant surgery. ‘If it seems likely that you will have very thin hair at the back and sides when your hair loss is complete — because your father and other male relatives did, for example — it probably wouldn’t be worthwhile.’

Marzola disagrees. He says that if you have more hair at the back and sides than on top, something can be done, even if it is only micrografting to remove the shiny bald look.

In 1993 the first drug for hair loss, called Rogaine, was released in Australia. It is the topical form (you rub it on) of minoxidil, a potent oral drug for high blood pressure. When minoxidil was being tested, it was found to promote new hair growth. When it was applied to the skin (on areas with active follicles) it stimulated hair growth. It is made by Upjohn Pty Ltd, and according to the literature, it is the first treatment option scientifically proven to grow hair. It is indicated for male-pattern baldness.


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