“Hop on fin.” “Go Turkey.” “I need a shape up.” If these phrases prompt a pang of anxiety then you’ve probably worried about your hairline at some point. You’ve probably (like me) scraped your hair back in front of the bathroom mirror and tried to remember if your hairline really did always look like that. Affecting up to an estimated 50 per cent of men by age 50, and perceived as a crisis in attractiveness and masculinity, hair loss is a ubiquitous concern for young men in particular. It’s also, unfortunately, one that online spaces seem to increasingly take advantage of.

“I play to hundreds of thousands every year and confidence is everything. Thinning hair is not an option,” proclaims McFly guitarist Danny Jones in an endorsement for online hair clinic MANUAL. While this isn’t quite true (thinning hair is an inevitability for many, men especially), and purchasing treatments online definitely isn’t always the answer, what this video does highlight is how stigma around hair loss is starting to dissipate. Gone are the days of rampant tabloid speculation about Wayne Rooney’s possible hair transplant; today, celebrities speak about hair loss much more openly.

Similarly, hair transplant providers like Estenove, whose Istanbul clinic I visited last month, are also making surgical treatments more accessible than ever. Offering all-inclusive at competitive prices, hair transplants are no longer exclusive to the ultra-rich.

The increased availability of hair loss solutions obviously comes with its risks, not least of all unscrupulous businesses that seek to take advantage of your anxieties, but they also have an added benefit of normalising these concerns. Everything looks worse in the bathroom mirror at midnight, and talking about your perceived hair loss can help inform you on whether you should pursue medical treatment. So, let’s talk about it.

HEAR FROM A PROFESSIONAL

“95 per cent of our patients are male, mostly because of androgenetic factors,” Estenove’s doctor Zafer explains, “But we also see other causes like hormone imbalances, vitamin and iron deficiencies, and maybe stress.” In these androgenetic cases, Zafer continues, hair loss presents itself at the corners of the head, before gradually increasing in severity and spreading to the crown area. Meanwhile, stress and hormone-related hair loss often appears first as thinning at the top of the head.

The other five per cent of Estenove’s patients are female but, aside from trauma and stress-related hair loss, the causes are usually different. “Too much microblading on the eyebrows can mean that hair never grows back and, after that, they may want eyebrow transplants,” he explains. “I remember when I was a teenager, thin eyebrows were trendy. These days, thicker eyebrows are the trend.”

Zafer also tells me that there are certain cases where a hair transplant is not possible – for example, if the patient is too young (generally under 25), if they have preexisting heart or brain conditions, or if hair loss is too severe, since the procedure relies on grafts from the back of the head. “In these cases, we might recommend other medications,” he explains, “That’s why experience [in hair loss treatment] is important. There is too much incorrect information on the internet and people often come in with unrealistic expectations.”

BE AWARE OF POTENTIAL SIDE EFFECTS

Of these other medications doctor Zafer mentioned, finasteride and minoxidil are by far the most common. Finasteride tackles male pattern baldness in particular by inhibiting the production of the dihydrotestosterone sex hormone, which can contribute to the shrinkage of hair follicles, while minoxidil works more generally by stimulating hair regrowth. Both of these are readily available from online providers and can be effective in preventing hair loss early on, but do also come with a range of side effects including erectile dysfunction and decreased libido – which many online vendors conveniently (and disconcertingly) also stock medication for.

We spoke to one recent Estenove hair transplant recipient, football influencer Mark Harlow, who explained how his hair loss had caused him to lose confidence while filming his social media content and was worried that his 11-a-side teammates would make comments about his appearance. Harlow described how he started taking finasteride to maintain the graft – a practice sometimes recommended as part of the recovery process. “I started on the tablet but had some side effects, libido being low,” he tells Dazed, “I changed to a topical finasteride spray and so far that’s been great with no side effects.”

Elsewhere in our conversation, Zafer describes how his clinic has also seen a recent rise in bodybuilders seeking hair transplants due to abuse of testosterone-increasing steroids. What begins to emerge here is a cycle of male insecurity leading to further knock-on effects, from testosterone abuse to hair loss medication to erectile dysfunction treatment. Again, perception and managing expectations play a huge role here, and it is important to be aware of the side effects of any treatment you pursue.

WHAT ABOUT A HAIR TRANSPLANT?

“Without a doubt, I am planning to get a transplant at some point,” another hair loss sufferer, Eesah*, tells Dazed. “It is clearly a very unregulated and predatory landscape with many surgeons who make peoples’ live worse, so I have been doing a lot of research to ensure I pick an ethical and able surgeon when I take the plunge.” Indeed, some hair transplants can lead to more harm than good – from causing infection and scarring to simply looking a bit funny. So, according to Estenove’s doctors, here’s some insights into the process.

“There are written and unwritten rules about hair transplant surgery, that’s why experience is important,” Zafer tells me. “In America, the procedure starts around $20,000 to $40,000, but the results can be disastrous. It’s not related to price, it’s whether they have experience.” This medical experience can include knowing which techniques to use depending on the type of hair loss, but also understanding a patient’s expectations.

“The first rule of medicine is don’t cause harm, but what is harm? There’s a balance between the patient’s medical conditions, their aesthetic conditions, and their psychology,” Zafer continues. “Too many patients aged 20-25 apply for transplants but some don’t even have any kind of hair loss. We try to keep them within realistic borders.

But what is the process actually like? “The operation lasted around five hours and the anaesthesia was the only painful part, which lasted five minutes,” Harlow tells Dazed around one month out from his surgery. While exact techniques can vary from clinic to clinic, with a big variable being whether patients are put under general anaesthesia, the vast majority of hair transplants involve taking grafts from a donor area (often the back of the head where hair is thicker) and implanting them throughout the scalp, before sealing the area with stitches.

Following the operation, patients then return to the clinic the next day for washing and a check-up, before entering the aftercare period, throughout which your doctor should be in regular contact. As Zafer mentioned, the success rate of a transplant can vary greatly, and no operation is guaranteed, but Estenove advertises a 90-95 per cent effectiveness for their surgeries. 

“My hair has now gone through the shedding stage so I’m looking a little bald again, but this is all part of the process and five months from now I should start to see great progress,” Harlow concludes of the process which ultimately takes around a year to complete. “The first month I took everything easy. No gym or anything like that. But now I’m in the second month and I’m back to my normal routine.”

PUT IT IN PERSPECTIVE

I’d heard rumours about how every Ryanair flight to Istanbul is full of hair pilgrims seeking salvation. Sat on the plane out there last month, I spotted a few protruding widow’s peaks that might have fit the bill. But then I heard them speaking Turkish. I realised that I’d been a bit judgmental – these weren’t men insecure about their hairline, but just regular people heading home from a holiday. In some sense, this struck me as a metaphor for hair loss anxieties as a whole. Perception bias is a powerful thing, and fixating on your hairline can easily make it seem much worse than it actually is.

Hair loss has affected people for generations – even most famous bust of Julius Caesar in Turin, Italy, stands at a cool stage three on the Norwood scale of hair loss. So, whether you choose to pursue treatment or not, make sure not to internalise your anxieties, discuss your concerns with friends and professionals, and consider any treatment in view of their potential side effects. After all, everything looks worse in the bathroom mirror at midnight.

* Name has been changed