Five thousand years…

That’s about how long men have worried about their hair loss. For 5,000 years men have felt the pressure to look their most fit, masculine and virile which included a full head of hair. From Ancient Egypt to the Middle East to Biblical times, men have been attached to their hair – even if they didn’t have any.

Kings 2: 23  From there Elisha went to Bethel. As he was walking along the road, some youths came out of the town and jeered at him. “Go on up, you baldhead!” they said “go on up, you baldhead!” He turned round, looked at them and called down a curse on them in the name of the Lord. Then, two bears came out of the woods and mauled forty-two of the youths. “And he went on to Mount Carmel and from there returned to Samaria.” (1,2)

From the story of Samson and his hair, which was the source of his strength, lost hair meant a loss of virility in the Middle East. Tired of being defeated and bested at every turn by Samson while he lived among them, the Philistines persuaded his second wife, Delilah, to coax the secret of his strength out of him so that they could finally get the best of him. After seducing him, Delilah had her servant cut his hair while he slept. He was later attacked, had his eyes gouged out, and was imprisoned. If you are familiar with the story, then you know he gets his revenge later, but only when his hair grows back.(1)

The ancient Egyptians were also obsessed with their hair and home remedies for hair loss were created to soothe the spirit of balding men back then. Some of the early Egyptian recipes for hair loss included:

  • Pound the beans of the castor-oil plant, soak the paste in oil and then massage the skull with the mixture.
  • Mix ground wheat, honey and oil, boil the mixture and then apply it to the bald patch.
  • Applying chopped lettuce to bald spots.
  • Concoction of fat from a lion, hippopotamus, crocodile, goose, snake, and ibex to be applied to bald skin.
  • Toes-of-a-Dog, Refuse-of-Dates, Hoof-of-an-Ass.
  • Honey, onions, lead, and alabaster, (2,3,4,5)

In 400 BC, the science of hair loss took a giant leap forward, and then quickly disappeared. As hair transplant pioneer Dr. O’Tar T. Norwood noted in a famous 1975 paper, (in which he established a classification system for male pattern baldness which would become the well-known Norwood/Hamilton Chart,) the Greek physician Hippocrates wrote in his Hippocratic Corpus: “Eunuchs are not subject to gout nor do they become bald.”

This observation made the connection between male hormones (later known as androgens) and baldness. Later, Aristotle was also interested as to why eunuchs did not get bald and were unable to grow hair on their chest.(6)

Despite these insightful observations, their respective cures for their own hair loss were uninspired. Hippocrates’ hair loss remedy was to prescribe cumin, pigeon droppings, horseradish, and beetroots while Aristotle preferred treating his own baldness with a topical solution of goat’s urine.

Even though the pigeon poop and goat pee cures didn’t work, their observations about eunuchs would go unappreciated for 25 centuries until an anatomist named Dr. James B Hamilton took up the eunuch observation once again and published a paper in 1942 entitled: Male Hormone Stimulation is Prerequisite and an Incitant in Common Baldness.(6b) In that research paper, Hamilton noted that androgens, the male hormone, was the main prerequisite for male pattern baldness. In another paper released in 1949, Hamilton had established a foundation for charting male pattern baldness which Norwood later improved upon, and which we will examine further here. Of these findings, Norwood wrote in his 1975 paper:

“Many of the things we take for granted were proven by Hamilton in some brilliant and remarkably simple experiments and observations. He demonstrated conclusively that the extent and development of male pattern baldness were dependent on the interaction of three factors: androgens, genetic predisposition, and age.” (6)

Hamilton also noted that in eunuchs and men who had failed to develop sexually (testes), male pattern baldness would not result even if there was a genetic predisposition for it. When these men were given androgens, their hair loss would occur as if it normally would have.

Modern Era

The last half century, 1960 to 2018, have offered major advances in the treatment for hair loss. Hair transplants went from being an academic notation to hair plugs to micro grafts to more natural looking follicular units that could be harvested in strips or one at a time (follicular unit extraction). A blood pressure medicine with an active ingredient called minoxidil was discovered to have an interesting side effect. Later, modern research led to the development of potent anti-androgen pills such as finasteride and dutasteride. Outside of FDA approval for hair loss, spironolactone, azaelic acid, and ketaconazole have shown SOME evidence (limited, small studies) of stopping the androgens that cause hair loss.

Although men today may stress about their hair loss, most are grateful and hopeful to be living in a time when effective treatments are available, and wait with anticipation for the day that a complete cure can be discovered.