If I’d always been as hairless as I am now, that would be one thing. But I can remember a time when I didn’t have to tilt my head back in photographs. A time before I wore beanies like self-esteem prophylactics, when I’d be OK about someone walking behind me when going down the stairs.

My aunt ran a leisure centre, and once a year throughout my childhood she would close it to the public and hold a Hanukah party for our extended family – often the only time I would see my relatives. Before fressing and presents, the whole family would go for a swim. On this one day, I would see my uncles and cousins, semi-naked, splashing about in a recreation of the placental gloop from which we all came. These bald, chubby men, covered in damp, matted hair everywhere except where it should be; sloppy otters slipping into a lake.

Then there was me. With thick, copper locks that looked golden under strip-lighting, I felt very different from these suburban, unsexual blobs on my family tree. I was a skinny-jeaned indie kid who knew where the good squat parties would be, and who got to snog girls a lot more attractive than I was. My hair was what separated me from them; it made me feel like a tearaway.

Then, at 16, I started to go bald. It was gradual at first, the size of a pound coin, but it kept growing: from bottle cap to blini to pickle jar lid. In the same way you can date a tree by counting the number of rings in its trunk, you can date old photographs of me by measuring the radius of the patch of skin on the back of my head.

Now I’m 24, and the sides of my head have fairly thick follicles, but the rest looks like barren outback with a few tumbleweeds floating across it. I hadn’t been fooling anyone else for years – my closest friends regularly told me just to take the leap and shave it off – but recently I stopped fooling myself. I went to the barbers, stared into the mirror and saw a face that didn’t make sense. It was a shoddy photofit of unsettling features: skin filled with teenage blemishes, the thinning combover of a backbench Tory MP. So I asked for a number one all over.

As the barber shaved the last hair from my head, I felt the identity I’d created for myself crumbling. This whole time, there had been a hairy, bald, Jewish pool monster living inside me, quietly biding its time – and now it was staring me in the face. I grinned through the cut and then ran away, feeling ridiculous, but also as if I was about to cry.

I know this seems both melodramatic and shallow – millions of men get on fine without hair – but it felt as if my youth had been cut short. Friends said it looked good, that bald men can still be handsome. (Although they never said “handsome”. They used words like “dignified” and “distinguished”. That’s fine if you’re 40, but at 24 you just want to be, you know, fit.)

And maybe the baldness alone would have been OK; I don’t think Michael Phelps would be too bothered if he started to lose his hair. But I am also a bit chubby and unathletic; my back and forearms are, goadingly, covered in wiry hair. My voice is uncommanding and my laugh girlish. I always have a cold and sometimes fail to notice a bit of hanging snot. I had, I thought, managed to offset those flaws with some other less grotesque qualities, but the baldness tipped the balance irrefutably into the red. I officially had an attributes deficit.

My grandad dealt with his baldness quite simply: he wore a toupee, which I suppose was the North Face beanie of its day; it still looked ridiculous. My choices are more complex, partly because baldness is something that’s increasingly sold to us as something that can be treated. Studies show that around 40% of men have noticeable hair loss by the time they’re 35. There are caffeine shampoos, such as Alpecin, and vitamin supplements that claim to stimulate growth; there are hair transplants and even stubble-like tattoos.

‘With a hat on, I look like a legitimate young person, someone who wouldn’t look out of place in an episode of Girls. With it off, I could be a 38-year-old risk assessor who collects model aeroplanes.’ Photograph: Thomas Butler for the Guardian

I wanted to talk to someone my own age who is also balding, and see whether they’d tried any of these options. I approached a couple of mates in their early 20s, so we could talk, baldy to baldy. Most of them were horrified that I thought they were losing their hair; the conversation stopped there. But I did talk to an old friend, now a member of a successful rock band, who didn’t want to be named. He’s the same age as me, although his balding isn’t as advanced. “I don’t think I would have done much about it if I wasn’t in music, but it started to really concern me,” he said. “We have our photo taken all the time, a lot of our fans are quite young. How would it look if I started to go bald? It actually made me really depressed.”

He had researched it heavily, and had tried taking hormones and visiting a hair-transplant clinic; but they advised against someone so young getting the treatment, and the talk of lifelong scalp scars had put him off. This possibility freaks me out a bit, too, so I book an appointment with the Belgravia Centre in London, a major clinic specialising in hair-loss treatments. The first room I’m ushered into feels like a dentist’s surgery. I sit down while my consultant takes a series of high-quality photos of my scalp, which are then thrown up on screens like giant, shameful x-rays. I’m shown which pattern of hair loss I have on a chart of photographs of men who have their faces pixellated, as if they are too ashamed to be seen by a stranger. I’m then told the advantage of a joint minoxidil and propecia treatment.

Minoxidil is a topical treatment, normally used in a serum or foam. It was initially tested as a drug to lower blood pressure, but men who used it found it led to hair regrowth. My consultant plonks a tub on the table – it looks industrial, like something you’d keep next to the Ronseal. It’s the main active ingredient in Regaine, the most popular treatment on the market, but the percentage of minoxidil is far higher in the Belgravia Centre’s own potion. Propecia is a pill you take daily, containing hormones that block the breakdown of testosterone.

I tell my adviser that I’ve already given both of these a brief go. Regaine kind of hurt my scalp and made no discernible difference. I also tried propecia (which is available from chemists if you go for a consultation) while I was at university, but it was very expensive, and, as a disorganised and often drunken student crashing at people’s houses or with my girlfriend, I’d forget to take it. I was also scared by the disclaimer that it can cause impotence, and I didn’t like the way that, to get a new set of pills, you had to sit in the Boots supply closet while one of their employees stared at your scalp, looking for progress.

The Belgravia consultant is unperturbed and says taking them in combination is the trick. She then ushers me into a second room, which is more like a meeting with a bank manager, even down to the soft lighting and posher chairs. I meet my “sales adviser”, who immediately tries to get me on to an expensive programme that includes vitamins, some kind of laser gun and quarterly head massages. We go through the prices: £1,570 a year with the fancy other stuff, £1,110 without. Oof. I tell her I’ll need to work out what this year’s tax bill is going to be first, and promptly run away.

I’m shown my pattern of hair loss on a chart of men with pixellated faces, as if they're ashamed to be seen

Finding independent academic or medical research in this area is difficult. Unlike, say, plastic surgery, which has a medical as well as cosmetic function, there is less public research or funding into hair growth, which is perhaps why it can feel like a wild west of snake oils and “miracle cures” at disconcerting prices.

But I do speak to one hair-loss specialist with a long career in public medicine. Dr David Fenton, like most in this field, has a private clinic, but he also treats NHS patients at Guy’s and St Thomas’ hospitals in south London, often working with children who suffer from baldness. His adult NHS patients are mostly women suffering from disturbances in hair cycles, and both men and women who suffer from alopecia.

I ask him for his take on the hair treatments available. We start with minoxidil: Fenton was involved in some of the original research that led to minoxidil’s initial sale to treat hair loss. He tells me that there are a lot of variables. “The higher the potency, the better the effect. Generally, the younger the patient, the shorter the history of the hair loss – and the more hair they have left, the more chance they have of response.”

And what’s a response? “A response can be anything from slowing down the process, to halting it altogether, to thickening the hair up to some degree. It’s unusual to take it back to where it was before. But you have to maintain the application twice daily and even then you’re looking at 50-60% chance of some response.”

With propecia, he says, there’s an 80% chance of response, and about 60% of patients have some regrowth. That sounds impressive, but considering most people don’t start trying to treat baldness until they’re pretty bald, that still means 40% of people have no more hair a year after using the drug than they did on the day they started taking it. Hardly a miracle cure, especially when you’re paying a couple of hundred pounds each month.

For these treatments to make the biggest impact, you need to act as soon as you see hair on the pillow. I start thinking about what I’d do if I had a son and he started to lose his hair. You would want to show your kids that beauty is skin deep, but you also want them to live a life of unbridled opportunity. It makes me feel terrible, but I know for certain I’d have him lathering on minoxidil every day from his 15th birthday.

Hair transplants are pricey, but people who do it seem to be thrilled: actor James Nesbitt has described his op as life-changing. Photograph: AFP/Getty Images

Did my dad have to make a difficult decision when he saw me going bald? I try to ask him for advice, but he does not give my situation the same emotional weight. He says the other day he was shaving his head, and when he squeezed out all the foam, he could see what he’d look like with white hair. Maybe I should try that, so I know I’ll want it. I sigh.

Dad went bald at 28. Even back then, he says, there were a lot of pills and potions, but he thought he’d just grow the hair he could. This resulted in a rather unsightly ponytail (“Which I had hoped would become cool, but it never did”). Although he’s never used it himself, my dad did, as part of his career as a radio DJ, do the voiceover for the first Regaine radio adverts in the UK, standing in the recording booth, bald as a coot.

I try to explain that things have changed since he went bald. There are more options that may halt hair loss if you’re willing to pay for them, but he’s nonplussed. I wonder if I should be, too. Why do so many men try these expensive and uncertain treatments? Why do I, and millions of other men, care about baldness?

A large part of Dr Fenton’s work is based around counselling and dealing with the psychological effects of baldness. “Some men, once they know that their baldness is hereditary and not a sign of illness, they may be able accept that,” he says, “and just be reassured their general health is good. It’s a normal physiological event, so there is no reason it should have treatment. Other people have some of their confidence and self-esteem built upon their appearance. Everything is geared towards perfection in the media, normally artificial representations of perfection. People get hooked on the idea that they ought to have that as well.”

Yes, the people on the covers of magazine are tall and skinny, and that creates pressure for us all. But while it would be socially unacceptable to mock someone for being fat or short, baldness remains fair game: in films, it’s used as shorthand for creepiness; on Buzzfeed, they mock-up bald celebrities with haircuts to show how much better they’d look.

Recently, I became single for the first time in a while and I suddenly realise that I am not just a single man, but a bald single man. I will have to deal with issues that I’ve never thought about before. When’s the right time to, you know, take my hat off? Girls don’t like it when you leave your socks on in bed, so I can’t imagine they’ll feel great about a bobble hat. Should I include “hat off” pictures on my online dating profile, or make a gag about it in my Tinder bio?

I can understand why more high-profile men are turning to the most drastic option available to them: hair transplants. Brought to public attention by the likes of Wayne Rooney, James Nesbitt and Rob Brydon, transplants are by far the most expensive option available to those seeking hair regrowth, costing between £5,000 and £30,000 (or as one website hilariously puts it: “£2.50 per hair”). It’s pricey, but people who do it seem to be thrilled: Nesbitt has described his op as life-changing. I have often thought about it, were I ever to become rich. Most people dream of property or cars; the first thing I’d do is get a hair job.

To find out just how rich I’d need to be, I visit a Harley Street clinic that offers transplant surgery. I wait in the reception, which looks like the lobby of a five-star hotel: 20 different flavours of herbal tea, a water fountain like the Starship Enterprise, scented candles for sale. After 30 minutes, I’m invited upstairs by a nurse. She looks at my scalp and frowns.

“Do you wear hats often?”

I tell her I wear beanies in winter.

“And baseball caps in summer?” she asks.

“Only sometimes,” I lie.

She tells me that all the hat wearing is damaging what little hair I have left. She frowns some more.

“Do you know about hair transplants?” she asks. “Have you looked them up?”

“A little,” I say.

She frowns: “Hair transplants are available only for some kinds of hair-loss patterns.” She is unimpressed by my all-over thinning, rather than a particular patch of loss. She says that, because I’m only 24, I will continue to lose hair, which makes taking hair from one area difficult. I imagine what I would look like with a pupil of transplanted hair surrounded by an iris of bare scalp.

Then comes the final blow: the nurse says I would not qualify for a transplant – “not now, and probably not ever” – because of the way I’ve gone bald. She asks if I’ve ever tried propecia, then tells me not to bother: it wouldn’t work for someone like me. Have I used Regaine? I tell her it stung. She says that’s because I’ve got eczema on my scalp: I need to see a dermatologist. Great, I think, and chalk up one mote minus to my deficit.

‘Why do so many men try these expensive and uncertain treatments? Why do I, and millions of other men, care about baldness?’ Photograph: Thomas Butler for the Guardian

So now I know that this is it: even if I become a millionaire, I’m always going to be bald. And it’s going to get worse. This might be all right if I could just have a shaved head, a sort of masculine sportswear look; but when I shave my head, I get bare patches where the hair should be. I will slowly go from Pitbull to John McCain to Harry Hill.

So I’m back to the hats. Sometimes I do this thing where I look in the mirror and take my beanie on and off. With it on, I look like a legitimate young person, someone who wouldn’t look out of place in an episode of Girls. With it off, I could conceivably be a 38-year-old risk assessor who collects model aeroplanes and owns two albums by the Script.

I called my friend in the band, and told him my woes. He was sympathetic, but then said something that really twisted the knife: “The thing is, in 20 years or so, they will definitely have cracked it. Medical science is always advancing, especially in cosmetic procedures where there is so much cash to be made. There will be a one-off pill you can take and no one will ever go bald. We’re going to be the last generation to look like this.”

I suppose that should give me comfort when it comes to my own children. But all I can do is imagine the family Hanukah party 30 years from now, with me a bald blob surrounded by hirsute, young men who have never had to worry about any of this.