OWING TO GENETICS OR INFECTIONS, SOME MEN ARE UNABLE TO GROW FACIAL HAIR. UNFORTUNATELY, TREATMENT OPTIONS ARE LIMITED.
A friend of mine, interviewing for a C-level job, was told by an executive coach to shave off his perfectly trimmed two-day facial scruff. But he liked the look, wore it anyway and landed himself a plum position with the company he wanted to work for. This friend is a young 40-something, but his adviser is in his late 50s.
Because he’s just a bit younger, my friend (who also shaves his head, by the way) is more attuned to executive fashion in a modern world than is his older mentor. He is part of a broad reach of younger men who work at all levels of the corporate hierarchy in that he is willing and able to sport some degree of creative facial hair. Chalk it up to athletes — Apolo Ohno and David Beckham come to mind — as we now commonly see soul patches, Vandykes (a mustache connected to a small beard on the chin), goatees (similar to Vandykes but without the mustache), designer scruff (the perfect one- or two-day growth from a clean shave) as well as stand-alone mustaches and full beards in the workplace and on the street.
The trend skews younger, but the man with a clear complexion and silver whiskers can command attention in any boardroom or sales presentation. Style consultants note that a shaved neck with a defining line of facial hair along the jaw can give an average face a better definition. Biological anthropologist Helen Fisher, Ph.D., a research professor in human evolution studies at Rutgers University who also writes for the dating website Chemistry.com, says that a beard communicates the presence of testosterone to women, such that to an ovulating woman, “a man’s rugged jawline [is] particularly attractive … and to further accentuate this facial advertisement of testosterone, men stroke their jaw or beard when they get nervous — a primordial gesture to show off their masculinity.”
All well and good — it’s nice that men can have as much creative leeway in grooming as the fairer sex.
But what about the guy with thin, asymmetrical or nonexistent facial hair? Is this common? And what can be done about it? Are these men shut out of the bedroom — perhaps even the boardroom?
Loss of facial hair due to infections
Just as there is male pattern baldness (androgenic or androgenetic alopecia), an inherited condition, as well as other types of hair loss (including alopecia areata, a patchy baldness), there can be hair loss on the beard. One such condition affecting facial hair is alopecia barbae, an idiopathic condition (of unknown causes, although some believe it might be due to an autoimmune disorder) that leads to hairless patches where there should be whiskers.
Treatment for alopecia barbae can include a topical or injection steroid (corticosteroids) application, which suppresses the autoimmune system. The consequence of that, however, can be side effects, among them, rosacea, skin atrophy, rashes from bacterial or fungal infections, allergic reactions or, occasionally, glaucoma.
Alopecia areata, which afflicts approximately 2 percent of the population, can affect the beard, eyebrows, eyelashes and scalp. This condition might be treated with steroids or topical minoxidil.
Other causes of facial hair loss result from bacterial, fungal and viral infections. Here are a few examples (note that folliculitis is an inflammation of the hair follicles, sometimes to such a degree that affected follicles die):
- Eosinophilic folliculitis. Generally affecting individuals with impaired immune systems
- Folliculitis decalvans (“tufted folliculitis”). When multiple hairs grow from a single facial follicle
- Herpetic folliculitis. Hair follicle infection from herpes simplex virus
- Gram-negative folliculitis. Typically caused by extended use of antibiotics to treat acne
- “Hot tub folliculitis.” Due to an infection by the Pseudomonas aeruginosa bacterium, frequently found in hot tub spas (the condition more often affects areas that are clothed)
- Pseudofolliculitis barbae. Ingrown hairs, as what occurs when a hair curves back into the skin
- Sycosis barbae (aka barber’s itch or sycosis vulgaris). Staph (staphylococcus) infection of the hair follicles
- Tinea barbae. Infection attributed to Trichophyton rubrum (a fungal infection)
- Trichotillomania. When individuals are involuntarily compelled to pull out their hair, which can include the facial hair as much as that on the scalp
As a rule, good hygiene can prevent some of these infections. People who wear headgear that involves a chinstrap, such as a biker’s helmet, may be more prone to some of these conditions.
In any event, inflammations and rashes should be addressed with prompt medical attention to minimize their effects and prevent facial hair loss.
Other causes of facial hair loss are trauma, radiation and chemotherapy. Treatment for these and several other facial hair loss conditions include hair transplants; however, each case needs to be approached on an individual basis.
Sparse facial hair due to hormonal factors
Some guys never grow much facial hair to begin with. Men of Asian extraction, including many who are fully or partly Native American, tend toward having thin or nonexisting facial and body hair. But in many cases, among men whose ancestry derives from Europe, Africa or South Asia, it is just a matter of family genetics.
Importantly, a lack of facial hair is an indication of low testosterone levels only in extreme cases (e.g., serious impairment of the endocrine system, sometimes diagnosed as hypogonadism). It is unlikely that “low-T” hormone replacement therapy would have an effect on facial hair.
One serious condition that is genetic in nature and which presents itself with minimal facial hair growth is Klinefelter syndrome. This occurs when the individual has an additional X chromosome. The condition is not noticed until puberty, when the boy with the syndrome develops less body hair and facial hair, has less muscle tone and might even develop breasts.
The person with this condition is usually sterile and might have learning disabilities. It is treatable, however, with hormone replacement therapy, ideally applied in puberty.
If they can fix eyelashes …
The U.S. Food and Drug Administration (FDA) has approved a pharmaceutical treatment for lost or diminished eyelashes (bimatoprost, or Latisse). Now, while one leans toward the obvious question — “What? No cure for cancer but there is a drug to make eyelashes bigger?!?” — it is fair to note the product was originally designed for people with glaucoma. In human clinical trials, darker and longer eyelashes were an unintended side effect, one that apparently has a market.
Let’s consider this a sign that all things are possible. If eyelashes can be fixed with a medication, maybe facial hair and even the hair on one’s scalp can be regrown entirely with a prescriptive drug at some future time. Until then, a good sense of style, being fit and promoting healthy skin — and the use of minoxidil in limited situations — may be the best a guy can do.