Case Study: Dennis

Toppik on 3 November 2014

‘One of my mates says to me, “You’re big, bald and beautiful!” These days I just shave it all off. I still have a few tufts of hair, but they look shocking.’

Dennis accepts his baldness: indeed, this acceptance was part of a conscious effort on his part. ‘I remember when I was 18, looking at older blokes losing their hair like I was. They were really miserable. And I remember thinking, “That’s not going to happen to me!”’

Dennis worked hard at not letting his lack of hair get him down. Over the ten years he’s learned ways of coping: ‘I think it’s got a lot to do with my attitude. I won’t let it worry me. I think it’s all in how you act. One thing I do worry about, though: I’m very conscious of the effects of sunburn. I have to be very careful and take precautions.’

Dennis and Thomas accurately reflect the two ends of the spectrum. Some people, and particularly those young men like Thomas who lose their hair in their late teens and early twenties, are absolutely devastated by their hair loss. They are supposed to be entering those carefree years after school. Starting university or their first job, appearance and sexual partners are all-important considerations. Essentially they are trying to find their place in the world, and just after they start getting over pimples they get hit with a far worse problem – one that won’t clear up by itself in a few years. Thomas has experience and will continue to experience marked effects upon his self-esteem.

Dennis, on the other hand, whilst unfortunate to lose his hair at such a young age, is fortunate that his belief systems allow him to accept his hair loss. He continues through life with little or no damage to his self-esteem and none to his social life.

Case Study Dennis Main

Thomas has at some point in the not-too-distant past taken a mental snapshot of the image he projects to the world. The image he holds in his psyche of his face and body are important to him, but now as he looks in the mirror he sees that image changing and, according to the advertising images conveyed to us, Thomas’s changes are not for the better. Thomas’s problem is that he feels exactly the same as he always did. This applies just as much to someone who is 40 and suffering hair loss, although they will generally not feel as cheated as Thomas. These feelings ultimately manifest themselves in a desire to return to the former and preferable self-image before the hair loss set in.

Hair has in the past performed a number of valuable functions for men and women.

  • 1. Warmth Many thousands of years ago men and women were covered in hair from head to toe. As prehistoric man covered himself in skins and fur, the need for body hair was greatly reduced. However, anyone who has had a very short haircut and stepped out into the cold will very quickly appreciate how much warmth a head of hair can provide. Modern clothing and housing have seen this function of hair relegated to insignificance.
  • 2. Protection Again, many thousands of years ago, ancient tribesmen grew quite large afros. These had a practical application: in battle, a large mass of hair would provide a protective barrier to what otherwise could be a life-threatening blow to the head or brain damage. Hair still has applications today for protection. When in a confined area or walking under a low tree, for example, your hair can ‘warn’ you that you are about to strike an object with your head and in many cases allow you to avoid contact. This is much the same way that a dog or cat will use its whiskers to ‘see’ in the dark. It is quite common for a bald man to complain that he hits his head far more often than his hirsute counterpart.
  • 3. Adornment Hair has for many years played a vital role in an individual’s expression of who they are. Hair is an important part of a person’s self-image and how they see themselves. Tribes in New Guinea and also Native Americans have worn various headdresses to signify their social standing within the group. Little has changed today, with hair being seen as an important fashion accessory for men and women.

The primary function of hair now is purely for adornment, and various studies attest to the effect hair loss can have on an individual and on society’s perception of that individual.

The Psychological Consequences of Hair Loss

Research conducted on an Old Dominion University in Norfolk, Virginia, in 1992 found that 84 per cent of balding men were preoccupied with their hair loss. The findings indicated that the emotional and psychological results of baldness are quite marked. Among the feelings these men expressed were:

  • Extreme self-consciousness
  • Feelings of helplessness
  • Envy of men who have a full head of hair

Single men in their twenties were most likely to suffer a severe loss of self-esteem.

Case Study Dennis Main 4

In a study conducted in 1972, researchers showed a series of photographs to a group of 60 people who were asked to make judgements about the person depicted in each photograph. The photographs were all of the same person, but had been modified by an artist. In some photographs, the person had ‘regular’ hair, in some he was balding, and in others he was bald. The results demonstrated just how powerfully we are influenced by appearance, especially in the presence or absence of hair.

Case Study Dennis Main 3

The person with the ‘regular’ hair was described with words like ‘handsome,’ ‘strong,’, ‘virile,’ ‘active.’ The ‘balding’ person was perceived as being ‘weak,’ ‘dull,’ and ‘inactive.’ The ‘bald’ person was perceived to be ‘unkind’ and ‘ugly.’

The results of this research suggest that the stereotypes concerning baldness are predominantly negative.

An interesting observation I have made over the many years as a hair transplant surgeon: some patients prior to surgery appear to have lost their drive in life and have let themselves go a bit. Their hair loss, it seems, has dragged the rest of them down with it. After the results of their surgery start to grow through you can see a change in their attitude to life. They take up an exercise regime, their diet improves, and when they come back to me at the 6, 9 and 12-month marks for post-operative check-ups, many of them seem to have lost weight, their skin looks better and they just seem more alive than they did prior to the surgery. Ultimately the surgery had little or nothing to do with this, it was just the catalyst for a change in outlook.

The Youthful Proportion

When discussing these stereotypes, it is important to look at how hair loss affects the appearance of the person experiencing it. The loss of the hairline can change a person’s appearance substantially. As the hairline recedes, the forehead can become the focal point of the face. Other facial features, such as the nose, eyes and chin, appear more prominent, or other features may not retain the attractive visual proportions they once did.

The youthful proportion is considered to be an equal spacing:

  • From the bottom of the chin to the base of the nose;
  • From the base of the nose to the top of the eyebrows; and
  • From the top of the eyebrows to the start of the hairline

With the onset of hair loss this spacing can change so that the region from the base of the eyebrows to the start of the hairline may now account for almost half of the facial image. This change in proportion alters the whole image of the face and has a tendency to make the flaws of the face stand out, in some cases quite prominently.

Hair loss affects everybody in different ways. The mere fact that you are taking the time and effort to read and understand this text suggests that at the very least you are concerned about the change in appearance you are currently going through.

I hope the information I present to you will give you an understanding of the process taking place within your body and allow you to tackle your hair loss problem as a savvy consumer, if you choose to.


  • Hair loss affects different people in different ways. It is only a problem when the person affected feels some adverse social or emotional stress, such as reduced self-esteem or a loss of self-confidence.
  • Hair loss changes the appearance of the face by shifting the balance of the face to the forehead, resulting in an aged appearance.