I have been bald for most of my adult life. My hair started ‘thinning’ in my late teens. By my early 20s I no longer needed to brush it out of my eyes when playing sport. By 27 it had gone from the crown of my pate (save for some fine ‘baby’ hair) and all that remained was a rim of hair stretching from around my ears to the back of my head. With time, the rim has gradually silvered. 

Obviously I was aware of my hair loss. I was teased a bit at school but this aroused in me little interest. Privately I was worried that my baldness might interfere with meeting ‘girls’ but this never seemed to be the case. And for my wife of over 40 years it has never been an issue of concern.

In reality, being bald has played little or no ‘negative’ part in my life, save letting in the cold in winter and exposing me to an added risk of sun burn in the summer. I have never contemplated wearing a wig; never thought of myself as being abnormal or my pate being in need of remedy; never has it made me shy or embarrassed. My (‘male-pattern’) baldness was just another aspect of the ‘me’ and one with which I was at ease. Indeed it had some advantages. I did not need a comb, my visits to the barber were brief and more bearable (the endless bombardment with trivia was shortened), and I spent little or no time drying my hair after a swim. Moreover, because in my early adult years my degree of baldness was unusual, I was more likely to be recognised and remembered, which seemed an advantage.  Being bald also made me look older which often helped. Interestingly, although I have never been particularly concerned about my looks, in a funny way I actually paid some attention to my pink dome. I felt it looked better when shiny, a sentiment that raised problems in later life. Conflicts arose when make-up artists tried to powder my pate (and my nose!) before a TV interview. I was keen to have my pate looking at its best; they were concerned that by reflecting the glaze of the studio lights it would wreck the picture. Usually it got powdered.

As a man at peace with his baldness there are two aspects of society that bemuse me, one providing some wry amusement, the other arousing feelings of contempt. The first relates to how baldness is treated as one of society’s ‘unmentionables’. How, if the topic of baldness arises in my presence, people become coy, sometimes blush, avert their eyes, and as quickly as possible changed the subject.  It is as though ‘baldness’ were something for which the ‘afflicted’ would be ashamed or embarrassed. For many, being bald is such an affliction that the word ‘bald’ is rude, indeed so impolite that children who dare utter it find themselves ‘shushed’; so naughty that its very mention by the Christmas pantomime dame has the audience in stitches. Although it may seem cruel, watching people squirm awkwardly around the issue does give me a smidgeon of pleasure.

In comparison with this, how I despise those men who go to great lengths (and often expense) to conceal, disguise or reverse their baldness, and how I abhor those enterprises which, for commercial gain, offer ‘proven’ remedies for a ‘condition’ that they promulgate as some sort of (universally agreed) scourge. What on earth goes on that drives a man to cover his bald pate with hair brushed forward or sideways from more luxuriant areas, or to have a silly row of hair transplanted across the forehead. There is something very wrong when individuals and society conspire to make normality an affliction 

Notwithstanding my erstwhile sentiments about baldness, I have to report an ironic twist of nature (and the pharmaceutical industry) and one of which I despair. My prostate is hypertrophied and for around two years I have been taking finasteride, a medicine that reduces the effect of my endogenous, maleness-promoting, hormones. In their new environment, the fine hairs on my pate have had a new lease of life and the one-time fluff has become rather more assertive, not to say visible and even worth a snip by the barber. Accordingly I have to bear a drug side effect which changes my persona, which I hate, and no doubt one which those who resort to hair transplants would crave for.  I have toyed with the idea of having the new hair shaved off so that I can revert to my easily-recognisable former self, but this would mean a level of deceipt and that is not my style.

Joe Collier is emeritus professor of medicines policy at St George’s, University of London