Toupée or Not Toupée, That is the Question Quiz

Answer: Androgenic alopecia

Androgenic alopecia, also known as androgenetic alopecia, is one form of alopecia.

Aaron certainly doesn't want rigor mortis as it's the stiffening that accompanies death. Lyssavirus is the family of viruses which includes rabies. Acute viral rhinopharyngitis is the common cold.

Answer: Chimpanzees

Chimpanzees, gorillas, orang-utans, uakaris and macaques are particularly noted for susceptibility to male pattern baldness, with products designed for the regrowth of hair often being tested on macaques.

Answer: No

Sorry Alana! Women can suffer from male pattern baldness too although the effects are different. In men, hair loss tends to occur through a receding hair line moving to baldness across the top of the head. In women, hair loss is typically from around the crown.

Answer: Compulsion to pull your own hair out

Trichotillomania is a compulsive desire to pluck hairs whether from the scalp, eyebrows and lashes or from other parts of the body. It often starts when the sufferer is relatively young and accompanies times of stress or depression.

Answer: It shows increased maturity and nurturing capabilities.

Some recent studies including that of Muscarella and Cunningham in 1996 have presented participants with a series of photographs of men with different degrees of face and scalp hair. They found that the greater the amount of hair, the more the sample identified aggression and immaturity. Conversely, people associated male pattern baldness with increased age and maturity.

In a 2008 study, Peter Kabai also hypothesised that male pattern baldness is an evolutionary development designed to diminish the risk of prostate cancer through the increase in ultraviolet radiation to the scalp.

Answer: A gene that controls hair growth

This was one of those joys of scientific research, a completely unexpected discovery. Researchers had been seeking merely to discover the function of the Sox21 gene. They experimented on mice that had been genetically engineered so that the gene was absent. What they found was that hair began to be lost from about the 11th day and by 20-25 days the mice were completely bald. Fur began to regrow but was then lost again with this cycle continuing for about two years.

The pattern was the same in both male and female mice.

Answer: Not too good. The scale only goes from I to VII.

Dr. James Hamilton first developed the scale in 1951 in the USA. His original scale had 8 stages, but was later revised by Dr. O'Tar Norwood in the 1970s. It is often known now simply as the Norwood scale.

Each stage is identified by way of side and top illustrations. It is possible to do this because, as the name suggests, male pattern baldness in men follows a discernible pattern. Stage I pictures a slightly receding hairline. By stage VII all hair has gone from the top with just a small amount remaining over the ears.

Hamilton claimed that his scale was so easy that anyone could use it with minimal training. To prove this he gave four patients from a mental hospital a 30 minute crash training course and then asked them to analyse a sample of 125 people. There was a 98% correlation between their diagnoses and those of Dr. Hamilton.

Answer: Genetically speaking, it's more likely that your mother made you bald than your father.

In male pattern baldness, the hair follicles are affected by hormones known as androgens and in particular an androgen called dihydrotestosterone. Genetics can play a part in making the body more susceptible to these androgens. The effect on the follicles is to cause them to narrow and shrink.

Men affected by male pattern baldness, like Aaron, have increased levels of testosterone in their bodies and this led to the myth of increased virility. There will, however, be no real difference until testosterone levels shrink to a minuscule amount.

Whilst it is theoretically true that the circulation of blood to the scalp could stimulate follicle growth, the results obtained from wearing tightly fitting headwear (constricting the flow) or standing on ones head (increasing the flow) will make no noticeable difference.

Aaron is fast discovering that there are as many myths abounding as there is good science.

The strongest genetic trigger for male pattern baldness appears to come through the X chromosome which is always inherited from the mother. This was reinforced by studies in 2005 (A. M. Hillmer et al) and 2007 (A. M. Hillmer et al). However, it would appear that Aaron's mother's family may not be entirely to blame. Two 2008 studies (Richards et al and A. M. Hillmer et al) also identified variations on a chromosome (chromosome 20) as being a secondary contributory factor and this can be inherited from either side.

Answer: No. Virtually all of them are unlicensed products.

As of 2009, just two of the vast number of treatments available were actually approved by the FDA. These were finasteride and minoxidil (Source : Wikipedia). Both of the drugs were discovered accidentally, being previously used for blood pressure and prostate problems respectively.

Here's what Aaron finds he has to look forward to if he goes down the "approved" route. Minoxidil was first approved in 1988. How it works, strangely, is not clear but it appears to act as a stimulant of follicle growth. Its potential side effects are slight but it can lead to water retention and can affect heart rate and blood pressure. Finasteride was first approved in 1992. It works by preventing the testosterone in the body from converting into dihydrotestosterone. Its most common side effects are of a sexual nature, inhibiting libido and potency in some men.

Answer: They all did

Engravings of Julius Caesar clearly show his male pattern baldness which he usually covered by wearing a wreath.

Studies, including those of J. S. Verinis et al (1971), Thomas Cash (1988) and Daniel Moerman (1988), consistently show that participants identify higher intelligence with baldness but, more negatively, decreased levels of strength and potency. (Source : "Hair!: Mankind's Historic Quest to End Baldness" by Gersh Kuntzman)

In recent years there has been a challenge to these societal norms from men such as Bruce Willis, Patrick Stewart and Michael Jordan who have sought to make a bald head more fashionable.

And that, after all, is the decision that Aaron will have to make for himself. In the words of the Bard (whom history has, perhaps mistakenly, portrayed as the bald Bard):
"Toupée or not toupée: that is the question:
Whether 'tis nobler on the head to suffer
The slings and arrows of outrageous hair loss,
Or to take arms against a sea of troubles,
And by a toupée end them?"