Spencer Stevenson was blessed with thick hair as a young man. He was handsome, too, with blue eyes and a dimpled chin. “They used to call me the Hoff,” the 44-year-old property manager recalls, referring to the former Baywatch actor and 90s pinup David Hasselhoff.

Then, when he was 21, Stevenson’s hairline began to recede and it made him so anxious and depressed that he became a near-recluse. “It was a constant drain on my personality,” he says. When he shaved off his thinning hair, the celebrity comparisons became less flattering: “They called me Grant Mitchell.”

Stevenson’s experience led him to become a mentor for balding men. For 15 years he has run an advice website, spexhair.com. He also presents The Bald Truth, an online radio call-in show, alongside Spencer Kobren, founder of the American Hair Loss Association. Progress has been steady, if slow, but Stevenson has started to see a shift from the negative notion of hair “loss”. “Now all we hear about is hair wellness,” he says.

Beyond the threat to his identity and self-esteem, Stevenson says the stigma of balding added to his suffering. With their clinical names and imagery of elderly men with comb-overs, treatments were about as appealing as piles cream. “It was all ads in the backs of magazines and there was nobody to turn to,” he says.

Now an industry built on fear, vanity and unspoken male vulnerability is undergoing a transformation. In rebranding hair loss as hair wellness as part of the broader rise of men’s wellness, treatments are being repackaged as aspirational products for millennials who are primed to talk about their problems.

Hilary Coles is cofounder of Hims, a startup that launched in San Francisco in 2017 and in the UK last year. “Hims puts together all the pieces of an incredible digital health experience,” says Coles in impeccable marketing speak. Its website looks like a store selling hipster houseplants or mid-century furniture.

In common with similar brands that have created the hair wellness market (in the US, where competition is much bigger, they include Keeps, Lemonaid and Nutrafol), Hims does not do much that is new. It has a bigger range in the US, but the UK site is a snazzy shop window for just two products, both of which have been around for years. One is sildenafil, AKA Viagra (Hims is taking on erectile dysfunction along with baldness). The other is finasteride, often branded as Propecia, a medication that inhibits the hormone that may lead to baldness in more than half of men over the age of 50.

Finasteride is not available on the NHS for hair loss. It does require a prescription, but many pharmacies can issue a private prescription via their own doctors, often after an online consultation to check if the medication is suitable (it can cause side-effects). There is also minoxidil, an over-the-counter medication commonly sold in the UK under the brand name Regaine, which stimulates blood supply to hair follicles.

Hims does not even provide its own finasteride pills. In the UK, it has partnered with Croydon-based Cedarwood Pharmacy to supply customers. Hims simply adds the packaging and its website. Following the example of Harry’s, the US shaving firm that turned razor blades into an aspirational subscription service (before it was bought last year by Wilkinson Sword for £1bn), Hims customers subscribe to receive a month’s supply of finasteride (28 pills for £30). The medicine comes in minimalist packaging with no mention of the word “bald”.

Coles, an MBA graduate from Canada, says work she did for a charity for injured soldiers schooled her in modern male mores. She says she became aware of the profound difference it made to men when they felt confident, in terms of their jobs and their roles as husbands and fathers. Along with Andrew Dudum, who has founded many startups, she launched Hims (which also sells women’s products under its Hers brand) to tap into the men’s wellness market.

Hims, which says it hopes “to enable a conversation that’s currently closeted”, declines to reveal the number of subscriptions it has, but the $100m (£75m) it has raised in funding suggests there is a market for men happy to pay for clever branding. I tell Coles it took me two minutes to find finasteride elsewhere online for half the price Hims charges. “Our ability is to build a relationship with consumers,” she says. “And if you’re helping more people access these products that will help them, that’s a positive.”

Stevenson is sceptical about the opportunism of the new purveyors of hair wellness, but supports their mission to improve access. “I had to learn all this the hard way, from insiders in forums who know where to get these medicines at a good price,” he explains. “But I think it’s positive that good companies are enabling people to keep their hair the right way.”

Quacks bearing useless potions have long filled the shadows in which men traditionally search for balding cures. “The industry has always been ruthless and brutal in the way it capitalises on vulnerability,” Stevenson says. He credits footballer Wayne Rooney’s headline-grabbing hair transplant in 2011 with beginning to drag the conversation out of the closet. “It was a turning point because of the way Rooney was so open and happy to talk about it,” he says.

Stevenson has tried everything himself at least once, and has spent more than £30,000 on hair transplants. He has a thick head of hair to show for it. In the procedure, individual hairs – or strips of hair – are extracted from well-served areas of the scalp and planted in the bald patches. As the technology has improved and awareness of the possibility has grown, demand for the procedure has soared. The International Society of Hair Restoration Surgery estimated that about 600,000 procedures took place in 2016, the last year it audited, more than double the figure four years earlier.

Stevenson says surgery should be a last resort and advises men to try the shaved look first. “It will be a lot less time-consuming and emotionally and financially draining than treatment,” he says. “Because once you start, you have to commit to maintaining it – it’s like having a fitness-model physique.”

At this point, I reveal my own status as a shaved-headed bald man of 37 whose hair started thinning when I was in my 20s, but who could not care less about it. If men are becoming more open about their problems and comfortable in their own bodies, shouldn’t demand for expensive, potentially invasive treatments be declining, however they are packaged? “I still think the vast majority of men would rather keep their hair than not,” Stevenson says.

As part of his research for the launch of a new range of slickly branded hair-wellness products, Jamie Stevens, 39, a hairdresser who lives in Buckinghamshire, commissioned a survey of 10,000 men across Europe. “So many men said they would rather have a small penis than go bald,” he says. “They said it made them feel less masculine, less attractive, less successful and less powerful.”

Stevens, who has one salon in London and another in Surrey, finds the same thing when he talks to his clients. He has had two hair transplants and makes a point of talking openly about balding. “Ninety-nine per cent of them have been like: ‘Oh my God, it’s so amazing to be able to talk to someone who knows what it’s like,’” he says.

Stevens, who also identified a market for products with minimalist packaging rather than the “shaming” images of the past, launched his own range, MR, in 2017 after three years of development. It includes shampoos that claim to protect hair, as well as colour-matched artificial hair fibres that are sprayed on in a way that disguises loss. Stevens secured a lucrative distribution deal with Boots last year and says he is about to launch in Waitrose.

“For years, it has pissed me off that women can get Botox, boob jobs or wear makeup, yet there is a taboo that men can’t do these things,” he says. “But now I know more men who have their eyebrows threaded than women.”

Stevens wants to launch a Hims-inspired subscription service and plans to open a men’s wellness clinic that will offer help with hair loss, but also body-hair removal, fat reduction and sexual health. Does he not think the rise of hair wellness products and the broader demand among men for cosmetic fixes is, well, depressing, even if it may also be a sign of progress?

“I do agree the world would be a much better place if we were all happy with what we have,” he says. “And it would probably be a poorer place for people who capitalise on insecurity. I know my wife wouldn’t have looked at me differently if I was bald now. But I didn’t do it for her, I did it for me.”