The days of the bald head could be numbered

With cutting-edge innovations giving follicles a new lease of life, there may not be any excuse for hair loss anymore... Photo / Getty Images

It is not something that usually troubles futurologists, who prefer to focus their attention on flying cars and averting the apocalypse, but it's reached a point now where somebody ought to ask the question: picture the streets of Britain in the year 2032 or beyond – do you foresee any bald men?

The inquiry is reasonable, given the direction of progress in the hair restoration market, a global industry anticipated to be worth more than $22 billion by 2028. Every few months, it seems, a new panacea is trumpeted in the fight against baldness, or if it's not new, it's "refined": transplants more effective and affordable than ever; "hair systems" that reinvent the toupé; "scalp tattoos"; pills that halt follicle deterioration; injectables that activate stem cells and restart growth ...

With the greatest of deference to the new heir to our throne – and indeed his brother, and uncle, and father – there really is no excuse for simply giving in to male pattern baldness anymore, potentially rendering glabrous gentlemen an endangered species. Unless they want to be bald, of course. But that's just it: hair loss is rapidly becoming a choice.

"Yes, to plenty of people it is now a choice. If people want to do something about their hair loss, there are proven treatments that can help. The problem with the general hair loss sufferer is they go into denial, and they leave it too late to actually act on it," says Spencer Stevenson, who runs the Spex Hair advice website and presents the podcast The Bald Truth UK. Depending on who you talk to, somewhere between two-thirds and four-fifths of all men will eventually be affected by male pattern baldness. Stevenson is 47 and has spent around £40,000 ($75,400) over the past 20 years attempting to tackle his own hair loss, including 13 transplants. He now has, if not quite a Samsonian head of hair, certainly no visible sign of loss.

"People usually lose 50 per cent of their hair before they realise it, or before they realise it enough to do anything about it. Surgery is a last resort. But if you act fast, you can prevent, and in most cases regrow, a significant amount of hair," he says.

Humans have been trying to counteract hair loss for about as long as humans have had hair to lose. Six thousand years ago, Ancient Egyptians rubbed a concoction made from dates, dog paws and donkey hooves ground up and cooked in oil into their shiny bald pates.

Ancient Celts stuffed mice into a clay jar, sealed it, buried it beside a fire for a year, and then took out the contents with gloves, lest hair sprout from their fingers. The Romans used myrrh berries as a shampoo – or, as in Julius Caesar's case, wore laurel wreaths in order to disguise receding hairlines.

One popular medieval recipe blended lizard tallow and swallow droppings into a hair gel. The Victorians took a pill containing the blood of a bull, believing the haemoglobin would encourage growth. Later, they simply believed good hygiene and daily fresh air was as good a cure as any. And for just as long have people laughed at the follicly scant. There is even a poor prophet in the Bible, Elisha, who in 2 Kings 2:3 "was going up by the way, there came forth little children out of the city, and mocked him and said unto him, 'Go up, thou bald head" Go up, thou bald head!'" Even Biblical children could be little b******s. "The 'cure' is always five or 10 years away, and then five or 10 years pass, and it's another five or 10 years away …" Stevenson says.

But there is no question we have come a long way since Graham Gooch and the late Shane Warne hawked dodgy-seeming hair loss treatments via TV and post campaigns (in reality, Warne had several surgeries).

In recent years, daily pills that inhibit DHT (dihydrotestosterone, the male sex hormone which causes hair follicles to shrink and eventually fall out), such as finasteride, have gained in popularity despite concerns over potential side-effects, which include impotence.

Generally sold as Propecia, finasteride comes with Stevenson's approval – "I've been taking it for 20 years and I fathered twins at a first attempt" – and costs £55 ($103.67) for a four-week course, which may sound exorbitant but is a bargain next to a transplant, which can be around £20,000 ($37,200) in the UK.

"The bottom line is that it's the best weapon we have against that process at the moment, building a defence against DHT, so the sooner you can get on that medication, the more hair you'll keep and be able to regrow further down the line," says Stevenson.

Finasteride is really for maintenance and prevention, though, as are DHT-blocking topical shampoos like GroMD. If a man acts too late, those won't be enough on their own, meaning something more significant is required. Fortunately, the options are many. Some are still in development, such as using cloning technology to simply recreate working follicles, and stem cell treatments which "hack" the scalp by micro-injecting a protein to reset follicles and promote rapid growth, But even the less scientific methods have come on.

One is a "hair system" – essentially a high-end toupée, grafted and plastered and cut and dyed to look perfectly disguised, which can look fantastic. That's an upside, as is the fact you can easily take it off if you have regrets. The downside is that it costs around £1000 ($1884.97), needs to be replaced at least every few months, and has to be reglued even more often than that.

So too "micropigmentation", which is effectively a method of finely tattooing the hairline, giving the illusion of a closely shaven head, rather than actual loss. It works brilliantly for filling in small gaps in thin hair, or on darker skin, especially if that person's haircut was already close. Otherwise, it can look like what it is: loads of dots coloured in.

And, of course, there are transplants, which normally require that the patient still has a decent amount of hair, since follicles are harvested from the back and side of the head (where, for most people, at least some hair tends to grow no matter how much is lost on top) and implanted on the frontal line either in clumps (follicular unit transplantation) or, increasingly, single hair grafts (follicular unit extraction).

James Nesbitt didn't get cold feet about having a hair transplant. Photo / Getty Images

"Clinics pop up all the time, in Turkey or wherever. There's an International Alliance of Hair Restoration Surgeons, and you should look for that seal of approval. This is surgery, remember, it's not a new coat," Stevenson says.

Instagram and its tendentious algorithms tend to direct people to those questionable overseas clinics, but even though hair transplants tend to require repeat visits for more top-up work, when done right, they are very effective. The likes of Wayne Rooney, who was so public about his hair transplant in his early 20s, plus the actor James Nesbitt and the Tottenham Hotspur football manager Antonio Conte, have made hair transplants entirely acceptable.

There are options, then, and this can only be a good thing. In 2017, Asda commissioned a survey of 2000 men to discover their feelings about going bald.

More than a quarter of those under 35 said they'd turned to drink and drugs to numb the pain of their hair loss. Almost half said they'd rather lose their home or sight in one eye than get a totally smooth pate.

"Once you're in the claws of hair loss, you get consumed by it, and then it gets worse because of stress. So from my point of view, it's about education, because you've got to truly understand that there are solutions, but not quick solutions. It's a cancer of the spirit," Stevenson says.

Of course, the alternative is that we shed our self-consciousness about it. After all, what better role models could the bald community have than Jason Statham, Mark Strong and Stanley Tucci, three of the most lusted after men on screen? Or Jeff Bezos, one of the wealthiest men on Earth?

It's something for the soothsayers to ponder, but there's a nice anecdote which tends to do the rounds.

Patrick Stewart, an icon of hairlessness if ever there was one, was once asked by Michael Parkinson whether his appearance was an issue when he was cast as Jean-Luc Picard in Star Trek: The Next Generation.

"At the very first press conference, a reporter asked Gene Roddenberry [the show's creator], 'It doesn't make any sense, surely by the 24th century, people would have found a cure for baldness?'" Stewart recalled. "And Gene Roddenberry said, 'No, by the 24th century, no one will care'."

We will see.