Hereditary hair loss can be a challenging experience for men, amidst youthful masculine appearance ideals, pressures to invest in costly commercial treatments and popular trivialisation. Yet qualitative research on how men adjust to losing their hair is surprisingly rare, including in relation to the meaning and significance of hair loss acceptance. Based on qualitative interview and photo elicitation research with 34 men aged between 18 and 49 who identified as having experienced hereditary hair loss, this paper explores the role of narratives of acceptance in their journeys of hair loss. The paper draws on thematic analysis and a more holistic examination of individual stories to assess how understandings about accepting baldness connect to the navigation of competing pressures and masculinities. We adapt ideas about acceptance and identity reconstruction from the sociology of health and illness to show how, following periods of struggle, men often can come to experience baldness as more reconciled with their identity, something often accompanied by the easing of anxieties or insecurities. Yet we also show how ideals about the desirability of acceptance can act as normative scripts that channel traditional traits of masculinity, placing pressure on men to perform acceptance, even in periods of struggle. Our research shows how ideals about accepting difficult forms of bodily change can be intertwined with competing sets of masculine pressures, offering possibilities to experience a profound sense of emotional relief, and of reconciliation between self and body, while also connecting to expectations than can render acceptance as compulsory and struggle as problematic.