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Hair Loss

May 22nd, 2014

Diffuse patterned hair loss (DPA) is characterized by hair loss (thinning) across the top of the scalp while the hair on the sides and back of the scalp remain intact. Because donor hair is taken from the sides and back of the scalp, those with a DPA hair loss pattern are often good candidates for surgical hair transplantation. Diffuse unpatterned hair loss (DUPA), on the other hand, is characterized by hair loss not only from the top of the head but also from the sides and back of the scalp. Because persons with DUPA hair loss have thinning on the sides and back, they are usually not good candidates for a hair transplant. DUPA is relatively uncommon in men but it is the most common type of hair loss in women. Both DPA and DUPA in men respond well to medical treatment using minoxidil and finasteride. Unfortunately, finasteride is not indicated for the treatment of hair loss in women.

Here is a more detailed summary of the video:

Dr. Bernstein: So genetic hair loss, or male pattern hair loss, also comes in a diffuse or more generalized form that we call diffuse patterned (DPA) and unpatterned hair loss (DUPA).

Diffuse patterned hair loss (DPA) is a variant of typical, common male pattern hair loss. With DPA, we see even thinning across the top of the scalp with no hair loss from the back and sides of the head. Because the hair on the sides and back is permanent, those with a DPA hair loss pattern are good candidates for a hair transplant, and they are good candidates for medical therapy as well.

Those with a DUPA hair loss pattern, on the other hand, lose hair not only from the top of the head but also from the back and sides. Because those with a DUPA hair loss pattern lose hair all over, there’s no permanent hair to use for donor hair, and this makes them poor candidates for a hair transplant.

In men, diffuse unpatterned hair loss (DUPA) is less common than DPA; perhaps only 5% of men with male pattern balding have DUPA. On the other hand, DUPA is the most common type of hair loss in women, and this is why women are not always good candidates for surgical hair restoration.

We diagnose DUPA in men by looking for miniaturization or changes in hair diameter. In DUPA, we find changes in diameter not only on the top of the scalp but also on the sides.

Diffuse unpatterned hair loss can be difficult to detect if someone is young because often this pattern of thinning does not become apparent until the late twenties. This is one of the reasons we don’t do a hair transplant on someone young, because if you have DUPA, the back and sides become thin, the scars may become visible – and that’s whether you do FUT or FUE. Finally, the transplant hair will disappear because the donor hair from the back and sides is not really permanent.

Both DPA and DUPA in men respond well to medical treatment using minoxidil and finasteride. Unfortunately, finasteride is not indicated for the treatment of hair loss in women.

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