Men, your bald spot looks great

The embarrassment many men feel about losing their hair doesn’t diminish over the generations. What changes are the available treatments and the coping strategies.

For instance, our fathers didn’t have Tressless, since 2011 Reddit’s “most popular online community for hair loss and balding,” where users post selfies of their hairline for crowdsourced advice, and debate the effectiveness of various pills, shampoos and lotions.

Nor did the balding men of yore have the option of hair-replacement surgery performed by a robot. The technology debuted in 2011 and “like everything, it gets better and better,” said Dr Robert M Bernstein, a dermatologist and Columbia University clinical professor who oversees the robotic procedure in his Manhattan clinic.

Indeed, much has changed in the world of hair-loss treatment in the years since Sy Sperling roamed cable TV advertising his Hair Club for Men, including the term itself. These days, it’s not “hair loss.” It’s “hair wellness.”

The phrase, which evokes the booming wellness industry that includes everything from supplements to oat milk, attempts to reframe the upsetting experience of losing one’s hair in a more positive light — notably by ditching the word loss. Hair wellness is playful and empowering. Hair wellness names a treatment Thick Head rather than the clinical-sounding Rogaine.

“It’s been a fear-based industry,” said Andrew Dudum, founder and chief executive of Hims, one of several newish brands promoting the idea of hair wellness. “This new wave of energy around being the best version of yourself is what we’re trying to capitalize on.”

Dudum said hair wellness is all-encompassing, a way to introduce men to the conversations around hair health that female consumers have been having for years, whether that be about excess oil, split ends, thinning hair or “volumizing.”

“In the men’s category, none of those things were talked about,” Dudum said. “Either you have hair or you don’t have hair. And if you don’t, here’s this archaic brand with a man on the beach with linen pants and he’s going to help you.”

Hims and its competitors, like Keeps and Lemonade, have also taken a modern approach to marketing and distribution. Hims provides access to generic versions of FDA-approved prescription drugs like finasteride and minoxidil through a direct-to-consumer platform, offering virtual consultations with a doctor. The medication can be purchased at a pharmacy in the patient’s state and delivered directly to the patient’s home. The use of generics keeps costs low. The Hims complete hair loss kit is $44 per month instead of around $130.

This process is meant to offer convenience and discretion to millennial men accustomed to ordering everything online. No doctor’s visit, no trip to the pharmacy, no hiding the bottle from romantic partners (the packaging looks attractive in an anonymous way).

But easier access to hair drugs with potentially serious side-effects, including impotency and dizziness, is “a double-edged sword,” said Spencer Kobren, founder of the American Hair Loss Association, a nonprofit consumer advocate group. (Finasteride also comes with a warning that there may be increased risk of an aggressive type of prostate cancer for men 55 and over.)

Bernstein agreed. “People have side effects with this stuff. Sexual side effects,” he said. When he prescribes Propecia, the market name for finasteride, he spends a half-hour counselling patients in person.

Dudum said Hims customers complete a comprehensive health evaluation through the platform, and are then routed to a qualified healthcare provider licensed in their state who is responsible for determining the appropriate diagnosis and treatment. They can speak to a licensed physician in their state through SMS, email or another form of telemedicine.

For those who don’t want to take prescription drugs or undergo hair-replacement surgery, there have long been a variety of natural remedies, which can be as dubious as they are creative, from hippopotamus fat in ancient Roman times to castor oil rubbed onto the scalp. Now, in the age of hair wellness, such treatments are pitched as one more tool for optimum health and performance, a kombucha shot for your follicles.

Perhaps the most buzzed-about new brand in this category is Nutrafol, which sells hair-growth solutions made of 22 natural botanic ingredients, including forms of saw palmetto, ashwagandha and curcumin. Giorgos Tsetis, the company’s co-founder and chief executive, is a former male model and industrial engineer from the Netherlands who began losing his hair when he was 22. Now 34, Tsetis tried finasteride for a time, but, he said, he suffered decreased libido and stopped taking the drug.

Along with a business partner, Roland Peralta, he began testing natural solutions that would promote what the company calls “hair wellness from within.”

Since it is a supplement rather than a drug, Nutrafol is not legally permitted to make claims that it treats the disease of hair loss. Instead, Tsetis, who last May spoke at a Goop summit in Los Angeles, talks about “adaptogens” and “targeting underlying causes” and “bringing your body back to your homeostasis.”

“I’m not saying we’re better,” than drugs like finasteride, Tsetis said. “I’m saying we have an alternative.”

© 2019 The New York Times Company