What is Diffuse Unpatterned Alopecia (DUPA)?

This question comes from a member of our [tag]hair loss[/tag] social community and discussion forums: 

I’ve been losing my hair for several years. I initially thought I suffered from [tag]androgenic alopecia[/tag] or [tag]male pattern hair loss[/tag]; however, members of online forums now say it may be [tag]diffuse unpatterned alopecia[/tag] or [tag]DUPA[/tag]. What is DUPA? Can it be fixed with [tag]hair transplant[/tag] surgery?

I’m not 100% sold on the idea of “DUPA” or it’s cousin “[tag]diffuse patterned alopecia[/tag]” (“[tag]DPA[/tag]”).

Traditionally, non-scarring alopecia is broken down into several categories: focal, patterned, and diffuse. Focal alopecia includes conditions like alopecia areata; patterned includes androgenic alopecia and [tag]female pattern hair loss[/tag]; and diffuse covers conditions like telogen effluvium, anagen effluvium, loose anagen syndrome, atrichosis, and hyoptrichosis. However, it does not – traditionally – include “DUPA” or “DPA.” Maybe the categorization is out of date, but I generally try to stay away from these terms – or at least from DPA. I do understand that “DUPA” is a good description for one clinical picture – which I will explain below.

I would classify hair loss fitting this diffuse pattern as follows:

Either: diffuse androgenic alopecia that is best described by the Ludwig and not the traditional Hamiltion-Norwood hair loss scale; OR you could call it diffuse unpatterned alopecia if you are experiencing thinning in the donor region (which is the only time I really think this term is appropriate).

Generally, DUPA patients aren’t the best surgical candidates. The only caveat to this is when preventive medications like [tag]minoxidil[/tag] ([tag]Rogaine[/tag]) and [tag]finasteride[/tag] ([tag]Propecia[/tag]) are used to stabilize the donor and allow for transplantation. Remember, it is important to undergo a thorough scalp examination with a trusted [tag]hair restoration[/tag] physician to fully understand your type of alopecia and treatment options.
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Blake Bloxham – formerly “Future_HT_Doc”

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