SARAH VINE: I need to deliver my actual hair again to life once more. I’ll have my very own blood plasma injected into my scalp and a cocktail of medication from a Harley Street dermatologist… and that is solely the beginning

Male pattern baldness. That was the diagnosis, many moons ago when, in my late 20s, I went to see my first ‘expert’ about my hair loss. I remember the sense of discomfort as he examined my scalp under a magnifying glass, sifting through my strands of hair with his fingers.

There may or may not have been a large grandfather clock ticking gloomily away to break the silence, but it feels like there was.

At the time I was just starting out in journalism. As a jobbing sub-editor on zero-hour contracts (Yes, kids, we had those back in my day, too!) the shifts were long and erratic, and the work stressful. Exciting, fast-paced, even at times thrilling – but stressful.

My hair, which had been shedding sporadically since my teens, was falling out quite badly.

My first port of call had been the GP. At the time GPs had not yet been turned into time-sheet automata, churning out prescriptions for patients they’ve only just met for the first time. She was familiar with my history of hair loss, and also very sympathetic. As a woman, she understood the emotions involved.

I was checked for PCOS (polycystic ovary syndrome), a hormonal disorder which can cause hair loss as well as other symptoms such as excessive body hair and acne, none of which I had. The results came back inconclusive. She also ran a series of general blood tests, which turned up mild anaemia, a vitamin D deficiency and low thyroid function.

She was reluctant to start me on thyroxine (for the thyroid) as my hypothyroidism was not yet as bad as it is today, and the medication can result in hair loss.

Instead, she put me on Dianette, an anti-androgen contraceptive which blocks the effects of androgens (such as testosterone) on hair follicles and recommended I increase the protein-rich foods in my diet – eggs, meat and so on. She also prescribed an iron supplement which, as I recall, gave me terrible constipation.

Did it work? Not really.

A bit, maybe. But not enough to resolve the problem completely. And being on the Pill made me put on weight, which I hated.

Meanwhile, my hair was still thinning at the front, just behind my hairline. So my next visit was to that ‘expert’ trichologist. Those words, male pattern baldness – so blunt, so brutal – stick in my mind.

As a young woman, with a head full of all the dreams that young women have, it marked me out as fundamentally un-feminine and faulty. I had a hair condition more commonly associated with testosterone-fuelled men.

Even the pattern of loss – my hair remained thick at the back but was thin and flyaway at the front and crown – was unmistakably male.

Once, in a restaurant, a waiter standing behind me had referred to me as ‘sir’. I was mortified, as was he, but it was hardly his fault. There are certain things that just signal femininity, and a balding pate is not one of them.

The reality of the situation was undeniable. While the physical effects of my condition were all too obvious, the psychological ones remained more hidden. I had been dealing with the problem from an early age, but I never got used to it.

Women’s hair has long been a cultural obsession. Think of Rapunzel, with her golden mane, long and strong enough to form a ladder for her lover; think of Goldilocks (the clue is in the name); think of Botticelli’s Venus.

Now think of Medusa with her mane made of serpents, drawing men to their deaths; think of Roald Dahl’s The Witches, revolting, evil creatures, each one bald as a coot. Think of women accused of collaborating with the Germans at the end of the war, their heads forcefully shaved as part of their punishment.

The message is loud and clear: a bald woman is an abomination, a hag, a crone – and very possibly evil. And while men who lose their hair find it just as upsetting as women, the way male baldness is framed is very different.

In men it represents virility, wisdom, power, maturity. It’s normal, acceptable, sexy even (think Jason Statham, Yul Brynner, Bruce Willis in his heyday).

In women it’s stigmatised, tragic, grotesque, heavily moralised. It’s associated with shame, punishment or illness. And if you try to cover it up, you’re mocked even more.

The world derides women who wear wigs, as poor Nicole Kidman discovered on the red carpet at last year’s Cannes Film Festival.

No wonder the hair-loss market is a multi-billion-pound industry. Products, treatments, transplants, lotions and potions, ‘hair replacement systems’ (AKA wigs): it’s a minefield of snake oil salesmen and empty hype, and it can be very hard to navigate.

Which brings me back to my so-called ‘expert’. A trichologist, of which there are many, of varying quality. This one was quite a famous one, based in Harley Street. I had high hopes.

He sold me some supplements and special shampoo and gave me some topical minoxidil (back then it had only just been licensed for the treatment of hair loss – it supposedly prolongs the growth cycle of the hairs and stops them falling out too soon).

Did it work? Honestly, not really. In fact, the only thing that ever really worked in all my years of hair loss was having my children.

On both occasions, while I was pregnant and breastfeeding with both, my hair stopped falling out.

I remember very clearly that I could run my fingers through it and it was of a normal thickness. But each time, as soon as I stopped breastfeeding and my hormones returned to ‘normal’, it would all fall out again.

At the time I didn’t realise this, but the problem with trichologists is that they are not medical doctors. They may be ‘experts’ in hair and scalp conditions, and they often have a lot of experience in the sector, but in essence they are non-medical.

This means a) they can’t prescribe and b) they are not regulated. They are trained via private diplomas or certificates, and they are unable to diagnose or treat wider medical conditions which may be at the root of the hair shedding.

At the end of the day, they may not be any more knowledgeable than a decent hairdresser.

By contrast, a dermatologist is a fully qualified medical doctor with a degree who has undergone specialist training. She or he is regulated by the General Medical Council (GMC) and has a clinical understanding of a wide range of conditions, such as autoimmune disorders (often a cause of alopecia areata), hormonal disorders and other systemic illnesses that can affect hair.

They can order blood tests, perform scalp biopsies (if necessary) and, crucially, prescribe medication. They may not be able to resolve the problem completely, but at least they have the right toolkit.

This is why, after years of hit-and-miss treatments and having almost given up entirely on my poor, weedy locks, I decided to have one last roll of the dice under the care of Dr Ophelia Veraitch, a dermatologist with a special interest in hair loss.

I actually went to see her with my daughter, for an entirely unrelated reason. But we got chatting, and I told her about my hair loss, and she asked to see what was going on.

At the time – this was a few months ago – I was still wearing my integrated hair system by Lucinda Ellery, which I have worn since about 2012, when my hair loss – exacerbated by the menopause and my worsening thyroid – had become too advanced to conceal.

It was so realistic that she didn’t even realise I had a problem. Lots of people didn’t; in fact, when I revealed the extent of my loss in the Mail earlier last month and then live on ITV’s This Morning, many readers and viewers wrote in to say they had no idea.

But after Dr Veraitch had a good look under the bonnet (as it were) she said she thought it was worth one last try.

There was a catch: I would have to remove the integrated system so she could treat my scalp. I balked at the prospect. She said she understood. We decided to do some initial blood tests to establish the basics – and I went away to think about it.

I must confess I was in two minds. My Lucinda Ellery system has served me well, and over the years I have fine-tuned it to a point where it looks incredibly natural. But something in me longed to give my real hair a final chance.

For all the system restored my confidence and hid the problem from sight, if not mind, I was always conscious that I was concealing a fundamental part of myself.

A big part of me wanted to ‘come out’, to show the world who I really was underneath that fake, glossy mane – and perhaps even start an honest conversation about this condition, which affects many women.

I wanted people to see the extent to which it can shape people’s personalities and life choices, to talk about how limiting and demoralising it can be – but also to see if, in this world of modern medicine, there was hope for women like me.

That’s why I decided to put myself in the hands of Dr Veraitch and embark on an extensive treatment protocol to see if I could get my hair back and, if so, what returns there would be.

My ambitions are modest: I don’t expect flowing locks or a thick head of hair. But if I can get enough overall coverage to wear it short and cropped, that will be plenty.

Normally Dr Veraitch would treat hair-loss patients over a period of three to six months.

But because of the severity of my hair loss (the clinical term is androgenetic alopecia; Ludwig Stage 3), it will require an extended period – approximately two to three years.

I am on a cocktail of drugs: spironolactone (an anti-androgen) and oral minoxidil, plus a topical lotion that I take at night containing finasteride and melatonin, with the addition of minoxidil and multivitamins (Dr Veraitch’s own formula) twice a day.

I take the spironolactone tablet at night as I find it makes me rather dizzy. It also seems to have made my tinnitus slightly worse and is a diuretic, making my skin very dry, but hopefully that is only temporary.

In addition, every two to four weeks I am to have a course of platelet-rich fibrin (PRF) at £1,200 per treatment; dutasteride mesotherapy (£580 per treatment); and polynucleotide injections (£500 each). If this works, each hair on my head will have cost a small fortune – but it will have been worth every penny.

So, what are all these treatments? The first, PRF, involves taking a couple of phials of my blood, spinning it in a centrifuge to separate out the plasma, and then injecting the pale pink, platelet-rich liquid directly into my scalp.

The natural growth factors in the concentrated PRF stimulate the body’s healing and growth processes, the idea being that this will help wake up my hair follicles (I have widespread hair follicle miniaturisation, which is when they basically shrivel up from lack of use) from their seemingly eternal slumber.

The process itself is not as bad as this picture makes it look (although I am quite good with needles generally). Dr Veraitch injects about eight syringes’ worth of the stuff all over my scalp using a very fine needle. I won’t say it’s painless, but it’s not the worst.

She works quickly, which helps, and the only really eye-watering bits are the sides, at the temples, and the front, where my hair is at its thinnest.

Later, at home, my head feels quite sore and slightly itchy; I also develop a headache, although this disappears with paracetamol. I take advantage of the pincushion effect of the needles to apply some extra lotion, as instructed.

I have yet to have the polynucleotide and dutasteride therapies, but Dr Veraitch warns me that the latter can be quite ‘stingy’, so I’m girding myself for that.

Again, it’s a series of scalp injections, only this time the aim is to block the androgen dihydrotestosterone (DHT), a hormone crucial in male development (voice deepening, body hair, muscle mass and so on) but which also causes male pattern baldness in genetically susceptible individuals, ie. me.

The polynucleotide treatment is similar to the PRF, only using biostimulators derived from fish that activate fibroblasts – cells that trigger the body’s own healing processes.

None of this is going to deliver instant results. But although any physical improvement will take a while – possibly years – to show, I’m already feeling the psychological benefits.

It’s not just that people have been, for the most part, incredibly kind and positive about it all, which is uplifting in itself. It’s also that there’s a freedom in no longer having to pretend, in having nothing left to hide. I’m not ashamed any more – and that, in its own way, is priceless.