The bald facts

In James Nesbitt’s case the ­transformation was astounding. The actor, who always had a  glint in his eye but who coupled  it with a receding hairline is now boasting a lustrous new look. He could now almost pass as George Clooney’s brother, courtesy of having a hair transplant from a clinic called Hair Restoration Blackrock in Dublin which he says has “changed my life”.

But Nesbitt, 45, is hardly unusual in suffering from balding.

“Male pattern baldness is far and away the most common form of hair loss in men,” says Marilyn Sherlock, chairman of the Institute Of Trichologists. “At the age of 30, 30 per cent of men are starting to lose their hair. By the time they are 70, it’s 70 per cent and it is genetically inherited.”

WIN A LUXURY CRUISE FOR TWO WORTH £2,500!

Men can also suffer hair loss as a result of ill health, medication and diet, although Sherlock says it is ­usually easy to spot male pattern baldness because men usually start thinning on the top or the crown.

She advises any man who feels he is losing his hair to see a registered trichologist (a specialist in dealing with the health of the hair and scalp) who can first rule out any other ­factors such as bad diet. “There’s no point in taking vitamins unless you’ve got a vitamin deficiency,” she says.

Male pattern baldness occurs when enzymes in the body convert testosterone into dihydrotestosterone (DHT). DHT has an adverse effect on hair follicles. It slows down hair production and produces weak, shorter hair, sometimes stopping it growing completely. So what are the “cures” being offered for this common problem and do they work?

THE HAIR TRANSPLANT

This is redistributing hair from the back of the head, where there is still growth, to balding parts of the scalp. The hair then continues to grow in its new location. You are not getting more hair, you are simply moving it. The operation takes several hours and sometimes more than one is needed.

Marilyn Sherlock’s says: “This can be done beautifully if performed by a good surgeon. The hair is there for life.

“But the whole thing depends on whether there is a good donor site at the back of the head. Some men go thin on the top but have a huge mop of hair at the back and for them, this method is highly satisfactory.

“However, not every man is suitable. You also need to know your family history. There’s no point transplanting hair in the front if you continue to recede as you will just have a space in the middle of your head.

“You also can’t use artificial hair because the body will reject it like a splinter.”

COST: About £3,000-£5,000

RATING: 10/10 if you are a good candidate and have a good surgeon.

THE LICENSED DRUGS

Minoxidil, sold over the counter as Regaine

It is a popular treatment applied to the scalp and, bizarrely, started life as a tablet for high blood pressure. Researchers noticed that patients began sprouting hairs elsewhere on their body as a side-effect. As a result, it was reformulated as an over-the-counter lotion.

About two-thirds of users see improved hair growth or reduced loss after about four months but you need to keep using it.

Sherlock says: “There’s a big question over how this works but clinical trials have shown it does work. However, it won’t work on a completely bald head. You have got to have something there.

“The best person to try this is a young man starting to lose his hair. It keeps the hair growing and regrows some lost hair but you have got to use it for life.”

COST: £25-£40 a month

RATING: 9/10

FINASTERIDE

Sold as Propecia

This is a tablet taken orally and is only available on private prescription. It works by blocking the enzyme that converts testosterone into DHT.

Sherlock says: “This is helpful in about 68 per cent of men. For testosterone to be converted into DHT (and so cause male pattern baldness) there must be a catalyst present.

“This drug kills the catalyst but you have one of three possible catalysts and this works on only two of them.”

COST: About £40 a month

RATING: 9/10

NATURAL REMEDIES

Sherlock says: “These can range from letting a cow lick your head to thrashing your head with nettles to standing on your head but none of them have been proven to work.”

COST: Usually free but your dignity goes out of the window

RATING: 0/10

SHAMPOOS AND CONDITIONERS

Most high street brands and salons have “volume” ranges to “plump up” hair. Sherlock says: “Minoxidil is the only lotion that will make your hair grow, shampoos won’t.

“However, there are shampoos, ­conditioners and mousse that claim to make the hair ‘look’ thicker, and they do. They either add moisture to the hair shaft to swell it up or they coat the hair shaft until the next wash. These shouldn’t be discounted as they can really help cosmetically.”

COST: From £2 to £25.

RATING: 7/10

CAMOUFLAGE SPRAYS

There are various types. Some attach fibres to the hair, some colour the scalp to make hair loss look less obvious and others simply act like a can of spray paint.

Sherlock says: “These can give an appearance of thickness. The Nanex spray, for instance, is pretty clever in that you spray on fibres which cling to the hair shaft to make it seem thicker. It washes out later.”

COST: Varies according to brand.

RATING: 5/10

LASER COMBS AND ELECTROMAGNETIC HELMETS

Laser combs such as the HairMax Laser Comb – a brush-like device that emits laser pulses as you brush your hair. It claims to “excite growth” when you use it for 15 minutes a day.

The BX3.4 Hair Loss Helmet emits electromagnetic waves. This supposedly “enhances the body’s ability to restore normal function and energy levels to its cells”.

You massage a blend of essential oils on to your scalp, put the helmet on and wear it for three 20-minute ­sessions a week for three months.

Sherlock says: “I hesitate to support these devices.”

COST: About £360 for the HairMax Laser Comb and about £750 for the Hair Loss Helmet.

RATING: 0/10

AND IF ALL ELSE FAILS... THE TOUPEE

Sherlock says: “Don’t dismiss the ­toupee. It may be the only option for some men who have gone completely bald and let’s not forget that hair loss can be devastating psychologically.

“They are generally attached with double-sided tape. If they are made of a good microfibre or European hair they can be quite effective.

“However, a bad one can be appalling. I’ve seen cases where toupees have been glued on and resulted in ­horrible scalp infections.”

COST: £500 to £1,000 for a normal toupee, depending on whether it is microfibre or human hair. About £5,000 for a glue-on one.

RATING: 0/10 for glue-on toupees, 5/10 for removable toupees.

For more information visit www.trichologists.org.uk 

HOW A NEW HEAD OF HAIR RESTORED THEIR CONFIDENCE

GARY MULLAN, 41, is an actor from Dublin who had a hair transplant at the same clinic as James Nesbitt – Hair Restoration Blackrock (HRBR), Dublin – in July this year.

“I first noticed I was balding when I was filming a commercial on set, and suddenly the whole production crew stopped and took me aside to blacken my hair. That’s when it really started to affect me. I did lots of research on treatments and decided the best way to go was with a transplant.

“At HRBR, I was first given an assessment – to see if I had a healthy amount of hair at the back of my head – and lots of tests. The procedure itself took about 10 hours so it was a long day but it’s done under local anaesthetic and was totally painless. The transplanted hair actually falls out after four weeks but the hair follicles are still there and the real magic happens about 12 weeks afterwards. You see your hair growing back – permanently.

“Really, it has been phenomenal. I’d given up ever having my hair again and now I have a full head – and it’s my natural hair. Hair loss is a topic that a lot of men don’t want to talk about but it affects them hugely. When you get a full crop back, you feel like you’ve got a new lease of life. Family members say it’s taken 10 or 15 years off me but it’s more about how I feel on the inside.

“It has also affected me professionally. I’d stopped acting when I was balding and now I’ve just finished a film and I’ve got a play coming up in January. I didn’t realise how much losing my hair affected me until I got it back.”

PAUL MOSLEY, 38, is a musician from London (www.paulmosley.com) who started noticing his hair was thinning a couple of years ago.

“I wasn’t bald but I could see I was receding and I was about a year away from having to shave it all off so that it looked OK.

“I’d already tried one shampoo which claimed it would give you a new head of hair but it just didn’t work. Then two years ago I was put in touch with Dr Stephen Whiteson who runs a hair loss clinic in Cheshire. He put me on the pill Finasteride and used a lotion he’d devised himself.

“Three months in I noticed a difference and by six months I had a full head of hair – and still have. But I do have to keep using it. I went away on tour in the summer and didn’t take the pills or lotion with me. After six weeks it started to fall out again.

“As soon as I got back I started straight away and now it’s getting better. It costs £700 a year and in my opinion it’s totally worth it. I’m definitely carrying on.”