I’d known the men sitting around the table for years, yet one evening I learned that each one of them had been keeping a secret from me, held back over the course of long friendships. The first confession was coughed up like a social hair ball: With an awkward laugh, my buddy said his anti-baldness pills, Propecia, had gone off patent. The rest of the room murmured a sigh of relief—as much due to the fact that they could now buy generic as that the topic was on the table. All except me, that is: I realized that I was the only man in the room with an all-natural mane. As such, I’ve never known firsthand the anxiety over going bald that the majority of the male population quietly harbors. (Some 35 million men in the U.S. alone are affected by male pattern baldness.)

At the heart of many men’s deep-rooted fears of losing their hair is a lifetime of messaging that a full head of hair means virility, strength, masculinity…in short, being a man. Is it any wonder some of us are so freaked out about going bald we’re willing to not just suffer in silence, but undergo all manner of treatment and maintenance—even at the risk of our emotional health?

Not long after that revelatory night, a lawyer friend admitted to me that he had recently undergone a hair nightmare. After stashing his Dopp kit in his checked luggage for a weekend away, the bag went AWOL. He spent a wretched, restive night waiting until he could call in a fresh Propecia prescription, and he could think of nothing but the warning on the label that stopping Propecia puts every safeguarded follicle at risk of self-destructing.

It gets worse. A doctor friend mentioned, in one unique case, a bipolar patient so traumatized by the hair-loss side effect from his mood stabilizer Lamictal that he stopped taking his meds altogether and relapsed. The message was clear: For modern day Samsons, it’s more manly to be mentally ill than thinning.

Thanks to the success of Propecia and its related rub-in treatment, Rogaine, there is a lot men can do. Thus remaining bald is practically taboo. (One Hollywood publicist even checks the weather forecast before sending her naturally chrome-domed client to red carpets; high temps mean his sprayed-on hair will melt, so she restricts him to a single photo op, then whisks him into the AC.)

But not every guy cowers in fear or combs over the shiny pate: Some 35,000 people belong to BHMA, or the Bald-Headed Men of America, an organization dedicated to bald pride. Others embrace hair loss in a different way: with a safety razor. The HeadBlade is specially designed to achieve that gleaming look, with an easy grip and wheels to steady a newbie’s hand. It’s available in a luxury limited-edition metal model, the S4 Shark. “As long as you have one hair on your head, like Charlie Brown, you’re still balding,” says inventor Todd Greene. “Shave your head, and you’re not balding anymore.”

Well said. But Vin Diesel notwithstanding, for now most everyone I know is just sticking with their Propecia.

Innovations in Hair Loss Treatment

Artas: Using a robotic arm, this machine transplants hairs piecemeal–rather than in strips–from the lower scalp, minimizing pain or scarring. 

PRP, or the Vampire Transplant: A platelet-rich plasma, made from the patient’s own blood, is slathered on transplanted follicles to accelerate growth. 

SMP, or Scalp Micropigmentation: The non-surgical procedure involves staining the skin with tiny dots of color to mimic the look of a freshly shaven head.