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The bald facts about hair loss

Rhee Song-il was born too early. If he could have waited 50 years or so, he might have avoided what is now his biggest worry ― going bald.
But as it is, every morning before heading off to work, Mr. Rhee, 27, brushes his hair with the utmost care. He cannot see what is bothering him, but he can feel it ― in more ways than one. The bare spot on the crown of his head has made him insecure.
“It was in July, when my mother was visiting from Busan,” Mr. Rhee recalls. “I was sleeping when she spotted the hair loss.”
Mr. Rhee says he was shocked, especially since no one in his family’s history was bald. Once nicknamed “Jesus” in college for his long silky locks, Mr. Rhee cannot figure out what is happening.
“It was really unexpected because I never thought I’d lose hair,” Mr. Rhee says.
Twenty years from now, some scientists predict, men will no longer have to fret over the uncertainty that has Mr. Rhee in its clutches. In her book “Tomorrow’s People: How 21st-Century Technology is Changing the Way We Think and Feel,” Susan Greenfield, a neuroscientist, predicts that genetic engineering will one day allow doctors to “cure” baldness at the fetal stage of human development.
But for now, many men feel like Mr. Rhee, who says: “I’m afraid of going bald.”
Hair loss can be traumatic, especially for a man in his 20s or 30s. Kim Taek-heyong, one of Mr. Rhee’s contemporaries, is under a frontal attack: His hairline is receding from his forehead in a classic case of male-pattern baldness.
“I’ve tried hair loss products, but they have not been effective,” Mr. Kim says. “I don’t know what I should do, and how am I going to go on a date? I’m even worried that I might not be able to get married.”

One possible source of comfort for these anxious young men is that their numbers are growing. According to Choi Jeong-hwan, a doctor at Cha and Park Skin Clinic’s hair center, the number of men in their 20s and 30s visiting the clinic has recently doubled.
Dr. Choi says the first signs of an increase in traffic coincided with the aftermath of the Asian financial crisis. What is more alarming, he says, is that a large number of boys in their teens are losing hair. Just five or six years ago, Dr. Choi says, the clinic’s main clients were males in their 50s.
There are no official data on hair loss among Korean men, but anecdoctal evidence suggests the problem is becoming more widespread, and, like baldness itself, it has a pattern. Local hospitals that have done their own, limited studies report that male hair loss appears to increase in October and November and decrease in March and April. No one has explained why.
But hair loss may be linked to some things within men’s control. Along with genetics, Dr. Choi blames inappropriate diet and lack of exercise. The young Korean men now losing their hair, he points out, “grew up consuming fast food.” He says baldness was historically rare in Korea “because in the Joseon dynasty the diet was heavily vegetarian.”
Stress is another factor, according to Dr. Choi. “Although there is no direct proof, most of the patients who come to the clinic are under a lot of stress, such as pressure from the college entrance exam or frustration over the high unemployment rate,” he says.
Pollution, which has been cited as contributing to the increase in the incidence of cancer and a direct cause of respiratory illness, is not seen by doctors as playing a major role in baldness. But Dr. Choi argues that it is a factor that cannot be ignored.
Many dermatologists claim that hair care products are a sort of Trojan horse for the forces of baldness. Consumer groups have argued for years that the chemicals in hair gels and other products, especially those used to color the hair, promote baldness.
Then there are the various nostrums. Many parents believe that shaving an infant’s head will stimulate healthy hair growth.
But, Dr. Choi says, a baby’s skin is very soft, and, therefore, shaving the scalp with something like a razor may damage the skin on the skull.
Native American folklore recommended rubbing red peppers into the scalp to stimulate hair growth. There is no evidence that the practice promoted anything except burns. Other shock treatments, such as beating the head with a brush, are equally futile. The brush, Dr. Choi says, damages the hair and scalp and may cause hair loss. One last tip from Dr. Choi: Frequent hair washing does not accelerate balding.
For some men, baldness is something that just happens. Since no one can choose their forebears, the best hope for retaining a dense thicket would seem to be eating nutritious food, exercise and managing stress. Since these factors can entail difficult changes in lifestyle, Dr. Choi says, baldness will continue to increase.
But all is not necessarily lost. “There are types of hair loss that can be reversed without special treatment,” Dr. Choi says.
From a professional point of view, Mr. Rhee is in the temporary hair loss group, whereas Mr. Kim is categorized as suffering permanent hair loss. In medical terminology, temporary hair loss is known as alopecia areata.
“It is easy to distinguish temporary hair loss, because the hair does not recede from the front; the loss occurs in unusual areas, such as the side of the head or the far back of the head,” Dr. Choi says. He says the cause of alopecia areata is still unclear but that most doctors think stress plays a major role.
Mr. Rhee started his current job in January. He says that in May and June ― the time his hair began to fall out ― he was feeling stress about his position.
Mr. Rhee says that his older brother had suffered the same type of hair loss, but after he quit his job, there was a remarkable recovery. Mr. Rhee says he believes that, like his brother, he may recover some of his lost hair.
Emotional stress has been shown to be a major factor in illness, from common colds to heart disease. Dr. Choi theorizes that a person’s immune system, activated by stress, attacks the hair’s roots.
“Once a person relaxes, that person recovers,” he says.
Dr. Choi says the rejuvenation takes about two to three months and that 70 percent of people suffering from alopecia areata recover, rarely experiencing further hair loss.
How do you know you are losing more hair than is natural? Dr. Choi says a person normally sheds 50 to 80 hairs a day, which re-grow as part of a natural cycle. Baldness occurs when the number rises. Permanent hair loss becomes well entrenched before it is noticed.
Complicating science’s quest for a cure, hereditary baldness seems to be the result of the interaction of several genes.
Although numerous products claim to offer hope, most are worthless. The only hair loss medicines certified by the Korea Food and Drug Administration and recognized by doctors are Propecia, made by Merck Pharmaceuticals in the United States, and minoxidil.
Propecia is a less potent form of finesteridem, a drug used to treat an enlargement of the prostate. Minoxidil is derived from a drug used to combat high blood pressure.
In Korea, Propecia requires a doctor’s prescription, whereas minoxidil can be purchased over the counter.
A more expensive option is hair transplant surgery, a process in which single strands of hair are moved from an area of denser growth on the scalp to a balding region.

Historically, bald pates were fashionable in some Asian countries. In China and Japan, for instance, it was sometimes customary for men to shave part of the head,
In Korea, though, baldness of any type was historically a rarity, and it remains a stigma today. Rationally, there is no reason to be ashamed of hair loss, but in Korea, baldness can make a man a less desirable mate.
“Young Korean women are reluctant to date bald men,” says Oh Mi-kyeong of Duo, a marriage consulting agency.
According to Ms. Oh, Duo has more than 40,000 clients seeking mates, split nearly evenly among men and women. She says that almost 100 percent of the women have asked not to be matched with anyone who is bald. “And that is why, to keep our clients happy, bald men are not permitted to become clients, and even if we did accept bald men as members we would not be able to set up dates for them,” Ms. Oh says.
The reasons female clients give for not dating bald men are that they find hair loss unattractive, and that other people might find the couple unattractive. They also say that baldness makes a man appear older than he is.
Duo is planning to hold a special event next month to make over people who are losing hair. “We will coordinate their appearance so that their hair loss will be seen as less of a detriment,” Ms. Oh says.
Kim Jeong-suk, 26, says she dislikes the idea of dating bald men. An employee of an Internet shopping mall, she says girls in Korea are not accustomed to dating men with any substantial degree of hair loss.
Mr. Rhee bemoans Korean society, which he says places too much emphasis on the way a person looks. In Korea, he says, being bald suggests you’re incompetent, and a person is penalized for something over which he has no control. He cites rumors that major companies prefer to hire people who are not bald, and says he is aware that girls prefer men who are not bald.
The hair factor is driving many balding young men to have hair transplants. “Think of it as improving one’s looks, which brings confidence. It’s very similar to why women undergo cosmetic surgery,” Dr. Choi says.
When it comes to hair, could “all or none” be the alternatives? Ms. Kim’s advice to men losing their hair is to shave the rest of it off. “It is better to date a guy who has a clean-shaven head then to date a bald person. It is different,” she says.

by Lee Ho-jeong