BACKGROUND: A Norwegian community study was conducted as an add-on to a large general health survey in Trondlag County, Norway, to characterize the cross-sectional relationship of patient perceptions with the degree of hair loss. METHODS: All members of the community were invited to participate in the general health survey and male participants, aged 20-50 years (n = 7,250), regardless of their degree of hair loss, were asked to complete a mail-based questionnaire. The questionnaire measured satisfaction with hair appearance, self-reported degree of hair loss, self-assessment of Norwood/Hamilton hair pattern, bother due to hair loss as well as concern about getting older due to hair loss, and included the SF-12 general health status questionnaire. RESULTS: Respondents (n = 4, 101) rated their hair loss on a 7-point, textual scale that ranged from 'a full head of hair' to 'I am bald'. The majority (63%) of participants reported at least a little hair loss and 27% reported moderate to severe loss. Using the Norwood/Hamilton hair patterns, participants rated themselves as class II (25.5%), III (8.6%), IV (8. 8%) or V or worse (19.5%). Relative to men without hair loss, a greater proportion of men with hair loss reported being bothered (20. 5 vs. 2.3%), concerned about growing older (43.4 vs. 10.6%) and dissatisfied with overall hair appearance (22.6 vs. 94%, all p< or =0.001). Men with hair loss also reported greater levels of perceived noticeability of hair thinning to others. CONCLUSIONS: A high proportion of Norwegian men aged 26-50 years self-reported having at least some hair loss. Results suggest that men who perceive themselves as having greater hair loss are more bothered by their hair loss, more dissatisfied with the appearance of their hair and have greater concern about getting older and losing more hair
