Medicalisation, pharmaceutical promotion and the Internet: a critical multimodal discourse analysis of hair loss websites

Abstract

This study conducts a critical multimodal discourse analysis of commercial hair loss websites. Specifically, I focus on eight sites which provide information about and promote the pharmaceutical hair loss treatment Propecia, a widely available medication marketed to treat male pattern baldness. I identify four salient discursive strategies through which the websites depict male hair loss and the Propecia treatment, namely (1) representing the balding man as type and outcast, (2) promoting the attractiveness and self-assurance of the hirsute man, (3) situating male hair loss in a scientific discourse and (4) encouraging consumers to self-evaluate their hair loss. By inducing insecurities in men experiencing hair loss and encouraging them to embrace pharmaceutical remedies as a viable response to male pattern balding, these discursive-semiotic strategies help to reproduce the contemporary sociocultural practice of medicalisation, the phenomenon whereby the natural processes of life are treated as medical problems. The findings of this study suggest that these promotional discourses play a role in transforming ordinary, benign ailments into illnesses, reconfiguring them as treatable disorders for commercial gain.

Keywords:

• multimodal discourse analysis
• medicalisation
• male pattern balding
• pharmaceutical promotion
• Internet hair loss sites

Notes on contributor

Kevin Harvey is a Lecturer in Sociolinguistics at the School of English, University of Nottingham. His specific research interest is in the area of discourse-based health communication, which includes corpus linguistic and multimodal approaches to health-related discourse.

Notes

1. An imaginative, if dubious, array of baldness “remedies” have long been used to treat male pattern hair loss. Up until the twentieth century, such treatments constituted little more than snake oil concoctions, of which some of the more absurd included mango oil, bear fat and deer marrow (Sherrow 2006). Yet, for all “the quackery of the past” (Conrad 2007, 35), there now exists a number of clinically validated therapies for moderate hair loss. The invention and promotion of these treatments has undoubtedly contributed to the medicalisation of hair loss (Conrad 2007, 34) since the creation of these modern medicines helps to consolidate the scientific conception of male pattern baldness which is now commonly accepted by the medical profession.

2. Due to copyright restrictions, Figures 1, 2, 4 and 5 appear in this article as drawings.

3. Despite its purported clinical objectivity, the Norwood–Hamilton Scale, as a diagram presumed to depict a medical, scientific reality, constitutes a piece of visual rhetoric, presenting as it does a particular account of the male balding process. For instance, the progressive phases of hair loss represented in the scale convey the sense of an inevitable progression to complete baldness: for men whose hair has started to recede, they might well be forgiven for thinking that their hair loss will ultimately progress to one of the later phases depicted in the diagram. Yet for all the ubiquity and seeming precision of technical diagrams such as the Norwood Scale, it is still not accurately possible to determine to what extent a man might actually lose his hair as he gets older (Ezaki and Kasori 1995).

4. Another (arguably more well known) example of a “me-too” or repurposed drug is Viagra (sildenafil citrate). As Conrad (2007, 41) observes, the discovery of Viagra was “serendipitous”. Sildenafil was originally tested by the pharmaceutical company Pfizer to treat angina pectoris (coronary heart disease). During trials of sildenafil, in which men were taking high, daily doses of the drug, a number of them reported that they experienced having firmer and longer lasting erections (Fishman 2007, 242). The occurrence of this unintended side effect resulted in an extremely profitably marketing opportunity for Pfizer: sildenafil citrate was subsequently branded as Viagra, a treatment for male impotence which went on to achieve “amazing levels of global recognition” (Tiefer 2006, 273). Sildenafil is also used to treat pulmonary arterial hypertension. Pfizer market this specific treatment as the proprietary drug Revatio.

5. During the course of this study the Propecia.com website was taken offline for maintenance. A new version of the site appeared in March 2012. Apart from a few minor changes (additional wordings regarding side effects) this latest version of the website is very similar to the original in terms of its linguistic content and visual arrangement.

6. Research into the psychological distress caused by male pattern baldness does in fact exist. Indeed the literature is quite extensive. Intriguingly, however, a number of these studies are, not unpredictably, sponsored by the pharmaceutical companies which manufacture hair loss treatments. For instance, one major multinational study which examined the psychological impact of male hair loss (Alfonso et al. 2005) was funded by Merck, with the authors of the study acknowledging the pharmaceutical company for its assistance in writing the report.