Response to Dr. Bauman: Hair Loss Is Not To Blame for Poor Self-Esteem

A couple month’s back Dr. Bauman left a lengthy comment, and I promised I’d respond. A combination of circumstances beyond the blogging world and the desire to weigh my words carefully have combined to delay this open letter far beyond what I had hoped. Regardless, I hope it adds something to the conversation.

Here is my original post with Dr. Bauman’s comment. I recommend getting up to speed before proceeding…

And now my response to Dr. Bauman.

Dr. Bauman,
Thanks for taking the time to stop by and comment. Funny you should mention a chipped tooth. I’ve had a small chip in a front tooth for years – ever since I tried to close the car door window with my head sticking out. Perhaps that tells you all you need to know about me. Never had any impulse to do anything about it… of course I’ve never had any impulse to do anything about my hair loss either.

I want to ask what I consider to be the next question: What is the appropriate treatment for hair loss? The answer most frequently given by media and industry, and the one that seems most obvious, is to address your hair loss. Baldness is considered the root cause; therefore, we should direct solutions at eliminating baldness.

I disagree with that answer. While I’ve not seen the research you cite, I contend that hair loss is rarely if ever a root cause of poor self-esteem. I believe baldness is at best derivative of the real cause. Hair loss is in the same chain of consequences as the psychological issues so often attributed to it.

In the case of disease, baldness is normally recognized as a symptom or side effect of the condition or treatment, even in the cases of alopecia totalis and alopecia universalis. As I understand them hair loss isn’t the cause but rather the effect of some other underlying dysfunction. I have no dispute with this approach, and in these cases, as I hope I’ve made clear here, I’m all for innovations that prevent or reverse hair loss.

In most cases, however, baldness is merely a sign of aging, and aging is not a disease. With the relatively minor and easily managed exception of sun burn and its associated increase in risk of skin cancer, I know of no physical risks associated with losing one’s hair. It is physically no more harmful to lose one’s hair than to have it turn gray. Therefore, there is no physical imperative that I can see to address age related hair loss.

Turning to the psychological effects, the impact on self-esteem is so far as I know is not caused by the hair loss itself, but once again the effect of something else. In this case the root cause isn’t some other physical dysfunction, but rather a social dysfunction, specifically in my opinion an obsession with youth. This obsession, which is largely manufactured by entertainment media, is what creates the psychological problems and not hair loss itself.

(This is why I levied such harsh criticism at the public television program. Public broadcasting ostensibly has education, the public welfare, and the advancement of society as its underlying motives, unlike private broadcasting which we know operates with a profit motive.)

Now if you agree with my assessment that the negative impact on self-esteem is not caused by hair loss but rather by the lens society gives us to view hair loss, then I suppose there are three paths of treatment you can pursue. One route is to help people conform to these external pressures. This is the path of least resistance, and therefore the one we should not be surprised to see so many taking. It is easier – and no doubt more profitable – to go with the current and help others to join in. It should not be hard to figure out that I am not keen on this approach.

A second treatment option is to help people to stand up under the social pressures. This is a harder approach, but in my opinion a far better one. This treatment acknowledges that the patient is facing an external cause and not an internal one. The youth-centered propaganda must be counteracted with a healthier perspective on aging.

The third option is to focus not on individual patients but on the source of problem, society itself. One can work to eliminate the problem by changing society’s youth obsession and therefore the message delivered by society about hair loss. Surely this is an uphill battle, but just as surely I believe it is one worth fighting.