Dr Asim Shahmalak2013-05-23T21:45:47-04:00Dr Asim Shahmalakhttp://www.huffingtonpost.co.uk/author/index.php?author=dr-asim-shahmalakCopyright 2008, HuffingtonPost.com, Inc.HuffingtonPost Blogger Feed for Dr Asim ShahmalakGood old fashioned elbow grease.New Research That Proves Just How Devastating Hair Loss Can Betag:www.huffingtonpost.com,2013:/theblog//3.24372822013-01-09T19:00:00-05:002013-03-11T05:12:01-04:00Dr Asim Shahmalakhttp://www.huffingtonpost.com/dr-asim-shahmalak/
The hairdresser - whose clients have included Kate Moss, Sienna Miller and Emma Watson - first noticed his hair was starting to thin on top in his early twenties.
But it took another 20 years for him to find the confidence to seek professional help.
Now, following a successful hair transplant, Mr Brown has talked openly about the agonies he suffered losing his locks - and how he hid his bald spot for years under his trademark hat.
He admitted: 'I live [my life] going through airports, from LA to London, and I used to panic about having to go through airport security.
'It got to the point when it was so bad, I didn't want to take my hat off. Those minutes before going through security and taking my hat off, they were torture for me.'
Not everyone reacts badly to losing their hair, but for some, like Mr Brown, it can be a genuinely troubling experience.
Don't just take it from me.
A major new study has revealed that hair loss can in fact trigger serious psychological breakdown - something my colleagues and I have believed for a long time.
Furthermore, researchers found it could even lead to exaggerated feelings of ugliness and, in the worst cases, trigger body dysmorphic disorder, where sufferers experience acute anxiety about their looks.
Doctors found that the 'enormous emotional burden' of going bald could lead in some cases to low self-confidence, mental disorders and even impaired quality of life.
The study is a major, and very welcome, piece of research into the psychological impact of hair loss.
Male pattern baldness (MPB), the main cause of hair loss, affects an estimated quarter of men by the age of 30 and two-thirds by the age of 60. So it is not necessarily someone else's problem for many British men - and, indeed, some women.
Don't misunderstand me, some men are happy losing their hair. Indeed, many wear their baldness as a badge of honour, feeling it suits them or reflects their personality. Others do not.
And until now the links between hair loss and mental issues among these men and women has been mostly anecdotal - shared via patient experiences, and in discussion among my colleagues in the hair replacement community - rather than scientifically proven.
Researchers at the Charité - Universitätsmedizin Berlin - one of Europe's largest and most prestigious teaching hospitals - studied hair growth, hair disorders and changes in hair density and quality among patients.
I have previously argued that the impact of baldness has been ignored or dismissed by many in the medical establishment.
I concede, of course, that losing one's hair is not in the same category as experiencing, say, a heart attack or stroke. The affects may not be immediately life-threatening.
The new research makes clear the impact of hair loss can have equally far-reaching, and, sadly, devastating consequences.
Recent successful hair transplants on celebrities like footballer Wayne Rooney, actor James Nesbitt and X Factor judge Louis Walsh have helped make the procedures more socially acceptable.
But solid research like that from the Charité - Universitätsmedizin Berlin will help educate those who see hair loss as a purely cosmetic issue.
Men and women alike go through a series of psychological stages when their hair thins. It might be difficult to measure, but there are all sorts of side-affects of that trauma on day-to-day life.
And the researchers also found that initial natural thinning could trigger self-inflicted conditions like trichotillomania - where sufferers exacerbate hair loss by repeated twisting or pulling.
Again, these so-called 'psychotrichological' disorders might be accompanied by feelings of disfigurement, depressive and anxiety disorders including social avoidance.
Sadly hair transplants are not available on the NHS except in the most acute circumstances. And they are not cheap.
Wayne Rooney's operation, where follicles are painstakingly matched over two days to the surrounding hair for a totally natural procedure, cost in the region of £15,000 - though there are cheaper procedures in the region of £4,000.
It is thoroughly commendable that people like James Brown are willing to talk about their own hair loss and treatment in public. It lends credibility to my own experience as a surgeon and, I hope, will help others muster themselves to take action.
As Mr Brown admitted: 'I have the confidence now, it's mine, it's not going to fall out - it's my hair, it's incredible and I really wish I'd had it done it ten years ago to save me those years of hell. It's incredible.'
The good news is that treatments will become cheaper over time as the procedures advance. The results will be even better and they will become more widespread.
Until then, hair transplants should not be seen as mere vanity measures.
Hair loss can have far reaching consequences - and an underlying impact on well-being - as this important new research has shown.
Also on HuffPost UK: ]]>Hair Loss is Traumatic: But Celebs Are Advancing the Cause of Treatmenttag:www.huffingtonpost.com,2012:/theblog//3.22028762012-11-28T05:37:06-05:002013-01-28T05:12:01-05:00Dr Asim Shahmalakhttp://www.huffingtonpost.com/dr-asim-shahmalak/
Ask anyone who's experienced thinning hair or receding temples or crown.
Men and women alike, although it is mainly men who suffer, go through a series of psychological stages when their hair thins.
Broadly speaking these can be characterised thus: Shock - Denial - Anger - Depression - Acceptance, not dissimilar to any other life-changing episode.
Some sufferers, more all the time, are seeking treatment and happily this can have a major impact on retaining existing follicles.
I won't repeat myself, but it is only in recent years that treatment and prevention - namely hair transplants and prescription drugs - have become widely available and socially acceptable.
Yet even now, young celebrities in particular who opt for treatment find themselves singled out for derision. I'm thinking of, among others, Calum Best (my patient) and Wayne Rooney (not my patient). Wayne, in particular, has suffered more than most for wanting to save his hair.
Thankfully, in putting his head above the parapet, metaphorically and literally, he's advanced public awareness of hair transplant surgery.
But the trauma of hair loss, and the impact it can have on other unconnected aspects of a person's life, confidence, self-worth, and so on, is not a new issue.
A few years ago former Liberal Democrat home affairs spokesman and one-time party leadership contender Mark Oaten, then a rising political star, was mired in a sex scandal.
I hope Mr Oaten will forgive me retelling his story here, after all it no doubt remains a source of regret and he has admirably moved on with his life and career.
But his response to a painful public experience was unorthodox, courageous even, and thus warrants retelling in the hope others may benefit.
Mr Oaten did not condemn the media, nor point to the pressures of life in the Westminister bubble, as he might reasonably have done and many before him have.
Instead, in an unusual and highly thought provoking response, he laid the blame for his behaviour squarely at the door of a mid-life crisis occasioned, he said, by the loss of his hair.
That's right, his hair.
Writing at the time in a compelling dispatch for the Sunday Times, Mr Oaten identified the loss of his hair as the trigger behind the increasing anxiety in his personal and professional life as an MP.
"Any television appearance would result in a barrage of emails, not about the issues I'd raised but about my lack of hair," he admitted.
"Whether supportive or not, they all asked what had happened to my hair."
He continued: "It's perhaps not surprising that I became more and more obsessed by its
disappearance. For me it was a public sign that my youth had ended."
Elected as a young MP with a floppy fringe, in just a few years his hair had receded dramatically around his temples and crown, necessitating a short crop all over.
Like many British men (an estimated quarter by the age of 30, and around two thirds by 60) he had suffered male pattern baldness.
Yet while Mr Oaten's public response might have been unorthodox for an MP, there was nothing odd about the feelings described therein.
For as I have outlined above, the loss of hair can be deeply traumatic. And trauma, however hard to gauge, can certainly influence both happiness and behaviour.
Thus, patently, the derision of those who seek treatment, especially if they are in the public sphere and therefore seen as fair game, is a ridiculous state of affairs.
Frankly, no one should underestimate the affect hairloss can have.
After all, would someone criticize if a person were having treatment for severe eczema, or another potentially disfiguring physical condition?
Of course not. So why do we allow baldness to be used in a pejorative sense?
'Baldy', 'slaphead', 'bone dome', harmless banter you might say, the language of the school yard. Maybe so, but also traumatic and bullying in some circumstances.
I'm not arguing in favour of political correctness. Just a greater understanding of the essential vulnerabilities we humans carry.
Self-confidence is of paramount important to well-being. And once that confidence goes, it can be hard to regain, leaving both professional and personal life badly exposed.
I have had patients who readily admit to worrying constantly about their thinning hair and tell me about the impact on their social lives: Innocent comments can be misinterpreted, the eyes of their friends seem drawn to their temples, everyone else has a full head of hair. Why not them? I don't exaggerate.
In a society where image has become so important, hair is crucial. And its loss can be devastating. Just ask Mr Oaten.]]>Barack Obama's Greying Hair Tells the Story of His Presidency So Fartag:www.huffingtonpost.com,2012:/theblog//3.21286292012-11-15T19:00:00-05:002013-01-15T05:12:01-05:00Dr Asim Shahmalakhttp://www.huffingtonpost.com/dr-asim-shahmalak/
Alongside the sense of relief etched on Obama's now heavily-lined features, it was hard not to be struck by another physical manifestation of power - he has gone badly grey.
Halfway through his eight-year term, Obama's hair is a bellwether of the unrelenting pressure heaped upon the man known as 'Leader of the Free World'. It tells the story of his Presidency so far as articulately as the US deficit or employment figures.
The President's once dark and closely cropped locks are now streaked with grey and palpably thinning on the crown and around his temples.
Indeed, Obama, whose youthful bearing and demeanour was a big part of his original sell to voters, admitted recently: 'I'm full of grey hair, but I'm not weary.'
While his crow's feet and greying hair are only the most visible signs of the pressure of his job, it would be a mistake to underestimate their import.
These very visible physical manifestations of stress are not simply a gift to the world's picture editors, and hair transplant surgeons like myself. They are an outward indicator of the internal difficulties of leadership in the modern world.
And Obama is not the first powerful man - and it is mainly men affected in this way - whose hair has suffered and signalled the strains of his job.
Nor will he be the last to display such physical symptoms of leadership.
Tony Blair went into office as British Prime Minister with lush brown hair and a sense of tennis-playing energy. Like Obama, his relative youthfulness was part of the anti-John Major sell to British electors tired of the grey men of the Conservative party.
After a decade in power, Mr Blair's hair had receded dramatically around the temples and on the crown, and was visibly thinning and streaked with grey.
Frankly, he looked exhausted.
Campaigning last week for elected police commissioners on behalf of his former Labour colleague John Prescott, Mr Blair looked much better.
He's got some of his facial colour back, and his hair looks healthier, but his decade at the coalface as PM aged him dramatically.
Unsurprisingly, it was the same for his successor, Gordon Brown.
Despite being nicknamed the 'Iron Chancellor', he became PM in 2007 with just a few steely streaks in his otherwise raven-dark hair.
By the time he left Downing Street, having gone toe-to-toe with global economic meltdown and a bitter and ultimately fruitless election battle, his hair was streaked in battleship grey. Truly an iron man, at last.
David Cameron, who was only 43 when he became PM, was showing greying hairs within a few months.
Human hair becomes grey - then progressively whiter - because ageing naturally lowers the amount of pigmentation in follicles.
This pigmentation, known as melanin, ceases to be produced by the body in sufficient amounts as we grow older. As this happens, new hairs appear grey, then white.
But it's not just our age that affects hair colour.
Family genes and stress - divorce, unemployment, a high-pressure job - can all play a role.
President Obama's job and age - 51 - make him high risk for greying and male pattern baldness. The latter is the main cause of hair loss, affecting an estimated quarter of men by the age of 30 and two thirds by the age of 60.
The bad news for Obama is that when he does retire in another four years - presumably to something less stressful - his hair won't return to its original colour.
Sadly, it's very common for those in high-powered jobs to suffer premature greying.
Stress, and changes in levels of the male hormone testosterone that a high-pressure job with long hours, high anxiety and lack of sleep can engender, play havoc with hair colour and density. In the very worst cases, they can trigger total hair loss, alopecia.
I'm not suggesting the 44th President of the United States needs a hair transplant. His hair loss is mild, but he should look after it. I'd recommend using the drug Propecia to help prevent any further loss of density and a special shampoo to nourish his roots.
After all, in today's society image is vitally important. The fact Obama himself mentioned his greying hair tells us that much.
For the President to project America as ready for the next challenge, with a new sense of energy and urgency, as he has done, it couldn't hurt for him to look and sound a bit more like the youthful Senator from Illinois of four years ago.]]>Prince William Will Be Bald by the Time He's 40 - But Not if He Follows Wayne Rooney's Exampletag:www.huffingtonpost.com,2012:/theblog//3.19362602012-10-08T19:00:00-04:002012-12-08T05:12:01-05:00Dr Asim Shahmalakhttp://www.huffingtonpost.com/dr-asim-shahmalak/
In Homer's Iliad, the Greeks spent hours combing and oiling their locks before battling the Trojans. And Samson reputedly lost his mythical strength after being shorn of his treasured mane by Delilah.
In the Biblical story and, throughout the ages since, the loss of hair has been equated to a feeling of weakness, a lack of masculinity, even impotence.
Modern men may no longer comb their locks before battle and Greek-style ponytails are out of fashion.
But we remain equally vulnerable to the vagaries of our hair, and its loss - usually by some combination of receding hairline at the temples and a thinning crown - can cause genuine agonies.
Male pattern baldness (MPB), the main cause of hair loss, affects an estimated quarter of men by the age of 30 and two thirds by the age of 60.
Until recently, the impact baldness might have on confidence and well-being was little understood or recognised by the medical profession at large.
Baldness was best left unmentioned, a taboo to be borne bravely and without comment. Wigs were poorly made and unsightly. More recently, the art of hair transplantation was in its infancy and the results could be patchy at best.
Thankfully times have changed, both in the understanding of MPB, its underlying causes and its impact, and its treatment. Medical technology has finally caught up, along with an increased and vital understanding of the importance of hair to feelings of self-confidence and masculinity.
And like so many fascinating aspects of the modern age, it has taken a celebrity to open people's eyes.
By taking the plunge, the footballer Wayne Rooney almost single-handedly helped transform British attitudes towards male hair loss, its treatment and prevention.
Last year the Manchester United striker went public following successful follicular unit extraction (FUE) surgery - where surgeons extract thousands of individual hair follicles before replanting them in the scalp where needed - taking to Twitter to post a picture of the results of his hair transplant.
Previously writing in his autobiography, Rooney had admitted staring at himself in the mirror and thinking: "Bloody hell, you're going bald and you're only a young lad."
Inevitably there was some sneering among rival fans when he went public. Just as previously there had been terrace chants about his hair loss.
In my own clinic, as a direct result of Rooney's example, I have seen a 25% rise in men coming to see me to restore their hair. He has become an unlikely example to those men who had previously suffered their own loss of hair in silence.
I have had patients who have felt their lives and even careers have been affected by their hair loss, more so than ever in the current tough economic times.
Another person who could learn from Wayne Rooney is Prince William. Sadly, our future king will be completely bald on top of his head by the time he is 40. William has been losing his hair since he was 25. His hair loss is even worse than his father Charles. And obviously his grand-father Philip is bald - and the family gene on his later mother Diana's side is not good.
There is a strong likelihood that any male child he has with Kate will also have the bald gene. Prince William has quite fine light brown hair. To restore the hair on top of his head to a reasonable level of density, he would need at least 3,000 or 4,000 hair grafts where hair is taken from the back of the scalp and moved to his crown - similar to the treatment Rooney had.
Commenting on the future king, the pop star Justin Bieber wondered aloud in the magazine Rollercoaster: 'I mean, there are things to prevent that nowadays, like Propecia. You just take Propecia and your hair grows back. Haven't you got it over there?'
Bieber didn't quite get his facts right. While the drug Propecia will halt hair loss, it will not help William's hair grow back. The only way he is going to cover that growing bald patch is with a transplant.
Among my own patients has been another celebrity, Dr Christian Jessen. The Embarrassing Bodies presenter might be better known for helping others confront their awkward ailments head on in the Channel 4 show. About his own case, he was equally forthright and took action to remedy MPB.
Sadly hair transplants are not available on the NHS except in the most acute circumstances. And they are not cheap. Rooney's operation, where follicles can be painstakingly matched over two days to the surrounding hair for a totally natural procedure, cost in the region of £15,000. Pocket money to a footballer perhaps, but a significant outlay nonetheless to Joe Bloggs.
The good news is that treatments will become cheaper over time as the procedures advance ever further. The results will be even better and they will become even more widespread.
Until then, hair transplants should not be seen as vanity measures, akin to a face lift or tummy tuck. I strongly believe a man's hair can affect his confidence, his dignity and even perhaps his livelihood.
Thanks to Wayne Rooney, many more men who would have suffered their hair loss in silence are plucking up the courage to do something about their thinning locks. Whether you're a Manchester United fan (as I am) or not, that's got to be something to applaud. I hope Prince William is listening.]]>