This web page was produced as an assignment for Gen677 at UW-Madison Spring 2009.
The psychosocial consequences of androgenetic alopecia: a review of the research literature
Cash, T.F. British Journal of Dermatology. September, 1999. Volume 141(3):398-405. doi:10.1046/j.1365-2133.1999.03030.x
I chose this review because I think it is a good representation of the social and cultural consequences of baldness. As was widely anticipated, the researchers found no evidence of positive perceptions or benefits to a balding person. The expressed social perceptions of balding individuals were modestly negative in almost every condition. The paper breaks down the studies giving supporting evidence into the three following catergories: the influences of baldness on social perception, the impact on self –image, and the impact of medical treatments on psychosocial functioning. For this review I will provide a good example of each and discuss how I interpret it.
The first, and most basic, study involved showing people pictures of balding or non-balding men. Both genders rated the balding person as older and less likeable. Interestingly, perceived intelligence was not affected by baldness. A related study showed that out of 522 elected government officials, the prevalence of balding was much lower than the average for all men of that age group. I think that these studies show that albeit subconscious, people really do judge on looks when making decisions. No matter how hard we try not to, that book is still judged by its cover.
A self-response study on the personal effects of balding had some results that surprised me. The researchers gave a 71 item questionnaire to 145 men and grouped them based on the Hamilton-Norwood scale (see home page). They found that the balding men were more stressed about hair loss and preoccupied over the situation more, but there were no associations with lowered self-esteem, sexual confidence, or social anxiety. However, there was a lack of body-image satisfaction in that group. To me it seems that although these men are not happy with baldness, as most people are not, perhaps some are beginning to come to terms with it.
As far as medical efficacy, there haven’t been a whole lot of studies yet. What was interesting though, was that patients with internal motives (to improve self-image) rated a more satisfying outcome than those with external (to get more girls or a better job). Also people with realistic expectations tend to be happier with the results. These two points seem to make sense to me. There is not a magic cure for this condition and thinking so will only make it harder.
My favorite part of the paper was the historical context that they put baldness into. For example, head shaving as a means of subordination in the military, or scalping enemies in battle. It’s obvious that throughout history hair has been an important symbol. I believe that people have evolved to look down upon balding. This and the fact that men are not in control of this type of hair loss make it very hard to deal with. As the paper concluded with, I too feel that the only way to completely remove the interior and exterior maladies of hair loss will be to prevent it from happening. Ultimately we(as males) would love to be able to come to terms with baldness, but in reality that is never going to happen.
