The Impact of Male Baldness

The pressure to look ‘good’ is strong. But what does looking good mean? Who decides what the male body ideal should be? We are inundated with images on social media of toned abs and chiselled jaws, and for the most part –a full head of hair and (trimmed) body/ facial hair. With this male ideal being the dominant image that we see, it’s hard not to be a bit despondent if we don’t match up. However, most of the images we see are not realistic (think filters!). Men, like women, can experience struggles around their appearance.  The charity CALM (Campaign Against Living Miserably) found that 35% of men aged 16-40 were unhappy with the way they looked and 48% of men said they had struggled with their mental health because of it. If we include men who had a physical condition which affected their appearance in some way, it’s likely we would see higher levels of concerns about appearance.

We asked Dr Glen Jankowski (pictured left) to tell us more about men’s body image and the impact of baldness on body image pressures. Glen is a Senior Lecturer in Critical and Social Psychology. His PhD was on the rise in body image concerns of men and the relationship with changes in commercial priorities.

Glen, what can you tell us about the male appearance ideal?

Toned, tall, tanned. And very often with a full head of hair too.

This describes key aspects of the ‘male appearance ideal’, the collective set of pressures on men to appear a certain way. Studies of Play Girl centrefold models1  to male action figures2 to general images of men in magazines and social media2--6   show most images of men conform to this.

Most men do not look like the male appearance ideal for one reason or another. This discrepancy between how men actually look – and how the male appearance ideal looks - can have profound impacts ranging from clinical disorders such as depression and suicidal ideation to less-recognised impacts such as appearance monitoring, social avoidance and low self -esteem7-8.

So what is the impact of male baldness on appearance pressures?

A full head of hair is a particularly unrealistic aspect of the ideal because most men will experience baldness over their lifetime9. What is the impact of balding (male pattern hair loss) on men? Controlled, statistical ‘meta-analyses’ of studies assessing the psychological impact, show men are mild to moderately distressed by their baldness10-11. This is an average; of course some will be very distressed. As one hair loss forum poster indicates: “I’ve been a prisoner of this hell for the past 20 years. It had completely taken over my life before (the baldness) even started. I’m not dead, but that’s all I can say to describe my living”12. However, many more balding men will be mildly or minimally distressed, especially with time. As another forum poster demonstrates: “Now that I’m bald, it’s not as crippling as I thought ...most of the time it’s all in your head anyway. [You think it’s] really the end of the world.  It’s not”.

Men’s distress is complicated!

The first complicating factor around male distress is the pressures of masculinity. Men do not just face pressures to look like the ideal man (the male appearance ideal) but they also face pressures to act like the ideal man (as women do to look- and act- like the ideal woman). This pressure to be masculine complicates men’s hair distress because admitting such distress may be seen as overly emotional, vain and unmasculine. For example, in a focus group study, one man indicated that: ‘[Men] don’t want to be seen to be weak by admitting that they don’t feel very happy with themselves’13. This is why Bald Cafe author, Harry James14 reassures balding men that: “If you want to really overcome baldness, then be prepared to get in touch with those negative emotions. Be reassured, taking action on those insecurities IS manly”. This is good advice and something that men who traditionally have been excluded from masculinity (such as gay men) might have already realised. Opening-up emotionally is a good, human-thing, to do.

The second complicating factor are commercial biases. Specifically, many of the studies (68%) on bald men’s distress are often funded or written by someone who profits from anti-baldness products. These studies are skewed to show greater distress than actually exists. For example, some studies (almost 80%) only recruit balding men that want anti-baldness products (such as pharmaceutical drugs). Or some studies will recommend anti-baldness products without discussing any of the products’ limitations such as limited, cosmetically meaningful, hair regrowth. It’s important that if men are distressed, they are told about and have access to effective and appropriate support. Commercial biases have also been found on some websites and forums about baldness and these can exaggerate distress too by depicting hair loss as more distressing, and discriminated against, than it actually is. For example, one anti-baldness advert implies that "an emerging bald spot... [can] damage your ability to get along with others, [can] influence your chance of obtaining a job or date [and can] even interfere with your job performance”19. When using hair loss forums, it’s important to remember that posts might come from companies selling products. It’s why Alopecia UK’s Men’s Chat Facebook group is valuable as this is a peer support space free from advertising.

It sounds like there’s a lot of advertising of anti-baldness products but these are not always the solution. What should people be doing to support men with hair loss?

Men should have objective information and resources about baldness. This will help them respond to their baldness in the way that is best for them (whether by accepting it, shaving their heads, concealing it or attempting to combat it). Bald men who are distressed should be given the option of psychosocial resources that can benefit them.

Alopecia UK has produced a guide to navigating helpful peer support resources which you can find here. 

A summary of mental health and wellbeing resources has also been pulled together here. 

If you want to find out more about the research around male appearance ideals, the psychology of male balding and also the commercial influences on male balding, Dr Jankowski has provided some references below. You can also find his blog, The Balding Buddy, here. 

  1. Leit, R. A., Pope Jr., H. G., & Gray, J. J. (2001). Cultural expectations of muscularity in men: The evolution of playgirl centrefolds. International Journal of Eating Disorders, 29(1), 90–93. https://doi.org/10.1002/1098-108X(200101)29:1<90::AID-EAT15>3.0.CO;2-F
  2. Pope Jr., H. G., Olivardia, R., Gruber, A., & Borowiecki, J. (1999). Evolving ideals of male body image as seen through action toys. International Journal of Eating Disorders, 26, 65–72. https://doi.org/10.1002/(SICI)1098-108X(199907)26:1%3C65::AID-EAT8%3E3.0.CO;2-D
  3. Deighton-Smith, N., & Bell, B. T. (2018). Objectifying fitness: A content and thematic analysis of #fitspiration images on social media. Psychology of Popular Media Culture, 7(4), 467–483. https://doi.org/10.1037/ppm0000143
  4. Jankowski, G. S., Fawkner, H., Slater, A., & Tiggemann, M. (2014). ‘Appearance potent’? Are gay men’s magazines more ‘appearance potent’ than straight men’s magazines in the UK? Body Image, 11(4), 474–481. https://doi.org/10.1016/j.bodyim.2014.07.010
  5. Law, C., & Labre, M. P. (2002). Cultural standards of attractiveness: A 30-year look at changes in male images in magazines. Journalism & Mass Communication Quarterly, 79(3), 697–711. https://doi.org/10.1177/107769900207900310
  6. Pope Jr., H. G., Olivardia, R., Borowiecki, J. J., & Cohane, G. H. (2001). The growing commercial value of the male body: A longitudinal survey of advertising in women’s magazines. Psychotherapy and Psychosomatics, 70, 189–192. https://doi.org/10.1159/000056252
  7. Jankowski, G. S., Gough, B., Fawkner, H., Halliwell, E., & Diedrichs, P. C. (2018). Young men’s minimisation of their body dissatisfaction. Psychology & Health, 1–21. https://doi.org/10.1080/08870446.2018.1496251
  8. Rodríguez-Cano, T., Beato-Fernández, L., & Llario, A. B. (2006). Body dissatisfaction as a predictor of self-reported suicide attempts in adolescents: A Spanish community prospective study. Journal of Adolescent Health, 38(6), 684–688. https://doi.org/10.1016/j.jadohealth.2005.08.003
  9. (2018, January 4). Hair loss. Nhs.Uk. https://www.nhs.uk/conditions/hair-loss/
  10. Frith, H., & Jankowski, G. S. (in prep.). Psychosocial impact of Androgenetic Alopecia on Men: A Systematic Review & Meta Analysis.
  11. Huang, C.-H., Fu, Y., & Chi, C.-C. (2021). Health-Related Quality of Life, Depression, and Self-esteem in Patients With Androgenetic Alopecia: A Systematic Review and Meta-analysis. JAMA Dermatology. https://doi.org/10.1001/jamadermatol.2021.2196
  12. Jankowski, G. S., Sherwin, M., Deighton-Smith, N., & Bell, B. T. (2021). ‘Just Shave It Off’: A Thematic Analysis of Men’s Baldness Forums. International Journal of Men’s Social and Community Health, 4(1), e54–e67. https://doi.org/10.22374/ijmsch.v4i1.55
  13. Adams, G., Turner, H., & Bucks, R. (2005). The experience of body dissatisfaction in men. Body Image, 2(3), 271–283. https://doi.org/10.1016/j.bodyim.2005.05.004
  14. James, H. (n.d.). Bald Cafe: Guide to going bald and being confident. https://cdn.shopify.com/s/files/1/0228/6308/5645/files/Bald_Cafe_Guide_To_Going_Bald_And_Being_Confident_HD_PDF.pdf?v=1584898934
  15. Alfonso, M., Richter-Appelt, H., Tosti, A., Viera, M. S., & García, M. (2005). The psychosocial impact of hair loss among men: A multinational European study. Current Medical Research and Opinion, 21(11), 1829–1836. https://doi.org/10.1185/030079905X61820
  16. DeMuro-Mercon, C., Rhodes, T., Girman, C. J., & Vatten, L. (2000). Male-Pattern Hair Loss in Norwegian Men: A Community-Based Study. Dermatology, 200(3), 219–222. https://doi.org/10.1159/000018386
  17. Kranz, D. (2011). Young men’s coping with androgenetic alopecia: Acceptance counts when hair gets thinner. Body Image, 8(4), 343–348. https://doi.org/10.1016/j.bodyim.2011.06.006
  18. Tang, P. H., Chia, H. P., Cheong, L. L., & Koh, D. (2000). A community study of male androgenetic alopecia in Bishan, Singapore. Singapore Medical Journal, 41(5), 202–205. cmedm.
  19. Tyler, B. J., & Cooper, R. A. (1996). Blinded by the Hype: Shifting the Burden When Manufacturers Engage in Direct to Consumer Advertising of Prescription Drugs. Vermont Law Review, 21(4), 1073–1106