Dr. Timothy Carman
Dr. Timothy Carman
Dr. Timothy Carman performs large sessions of ultra refined follicular unit transplantation with excellent results
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Diffuse Unpatterned Alopecia (DUPA)
What Is DUPA?
Diffuse Unpatterned Alopecia (DUPA) is a form of genetic hair loss characterized by diffuse thinning over the entire scalp. Unlike Diffuse Patterned Alopecia (DPA), DUPA lacks the stable permanent zone associated with other forms of alopecia.
Dr. O'tar Norwood defined DUPA in his 1975 seminole publication "Male Pattern Baldness: Classification and Incidence" as:
Diffuse, Unpatterened Alopecia (DUPA). In this type, there is a general decrease in the density of hair without any definite pattern, although it is usually more marked over the top and front. This type is common in women.
Identifying DUPA
Diffuse Unpatterned Alopecia patients have a similar pattern of hair loss to DPA patients but the balding tends to occur more rapidly. DUPA patients are also more likely to achieve the “horseshoe” pattern commonly associated with Norwood class VII baldness. However, unlike other forms of alopecia hair loss, the DUPA “horseshoe” takes on a thin and transparent appearance.
It is important that patients suffering from diffuse hair loss are properly diagnosed. While DPA patients are often good candidates for surgical hair restoration, DUPA patients typically make poor hair transplant patients due to the lack of a stable zone in which to harvest donor grafts.
Treatment for Diffuse Unpatterned Alopecia
Not a lot is known about the cause and treatment of DUPA. However, about half of males who suffer from this form of balding benefit from Propecia (finasteride). Unfortunately, DUPA is about 10 times more common in females for whom Propecia is not a treatment option.
Conclusion
Anyone suffering from diffuse hair loss should consult with a dermatologist or hair restoration physician for a proper diagnosis. This is especially true for balding men and women considering hair transplant surgery.
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How our Physicians are Chosen and How to Research Surgeons
As patients, we know that the physician you choose is the most critical decision in restoring your hair is the physician you choose. Hair restoration physicians' skills, experience, and talent vary widely, as do the end results, vary widely.
You must research and choose your physician wisely. After all, who you choose will determine how natural and complete, your new hair will be for the rest of your life. The surgeons selected and approved by our community have been scouted and vetted by the forum's highly esteemed senior valued contributors of the Hair Restoration Network. Our valued contributors have all spent years researching hair transplantation, and they have all had hair transplants. To ensure there is no conflict of interest, none of our valued contributors receive any compensation. They are volunteers who have shared their experiences and contributed for years to our community. Each surgeon has been approved based on their ethics, surgical techniques, results, and reviews. To support the costs of operating and promoting our community, the approved physician contributes a monthly fee to sponsor our community.
Their recommendation is continued as long as they continue to show evidence of excellent patient results and satisfaction. If a patient expresses concerns, physicians are expected to resolve their concerns. We ask that patients first contact a physician with any concerns so that they can resolve them before publicly posting.
Note - The hair restoration physicians recommended on this site are not a definitive list of all excellent hair transplant doctors. Nor do we warrant or guarantee the results of any of the physicians presented on this site. As always, we encourage you to do your due diligence in evaluating these and all hair loss physicians.
We offer the following suggestions for researching a hair restoration physician:
- Does the physician take a holistic approach to hair restoration? Your physician should help you evaluate all your options, surgical and non-surgical.
- Have they invested time and resources in large micro follicular unit hair transplantation sessions? Outstanding work requires a staff dedicated to and trained to use high-powered magnification to produce more than 2,000 carefully trimmed grafts per surgical session.
- Choose a hair restoration clinic that is patient-focused rather than commercially focused. Some clinics emphasize revenue, speed, and volume rather than dedicating the time and individual care needed to produce optimal results. These commercial operations typically rely on heavy advertising rather than satisfied patient or doctor referrals.
- Is hair restoration the primary focus of their practice? Outstanding results require a physician and staff to perform hair restoration surgery regularly. Doing hair restoration as a sideline and other cosmetic procedures may hinder their ability to do large sessions of highly refined follicular unit transplantation.
- How many patients has this physician produced excellent results for? Like any skill, experience over time is critical to acquiring the skill and judgment required to produce excellent results.
- Can the physician provide detailed patient before and after photographs? Do they also have patients who are willing to speak with you and meet with you in person?
What do their hair transplant patients think?
Ultimately, the most critical measure of a hair transplant surgeon's work is their patient's level of satisfaction. Find out what patients think of their physician's work by visiting our discussion forum or viewing hair loss blogs created by patients. View our standards for recommending hair transplant surgeons.
Find an excellent hair restoration physician in your area.
Send a Virtual Consult
This online feature enables you to fill out a hair loss questionnaire and email it to any of the quality hair loss doctors recommended on this site. You can even attach your photos. They will then respond to your questions and concerns.
Click here, to send a Virtual Consult.
Suggest a physician for recommendation on this site.
We are always interested in learning about outstanding hair restoration physicians. Click below to suggest an outstanding physician for recommendation on this site.
Click here if you are with a hair restoration clinic.
Click here if you are a hair transplant patient. -
Dr. Ted Miln
Dr. Ted Miln
Dr. Ted Miln is performing refined follicular unit grafting with incredible density, with results that are undetectable from his patient's native hair. -
Damkerng Pathomvanich, MD
Dr. Damkerng Pathomvanich
Dr. Damkerng Pathomvanich and his experienced staff regularly perform large densely packed megasessions with outstanding results. -
Finally Hair Loss Medication that works
While hair restoration surgery is now a proven treatment for restoring hair where it has been lost, Hair loss medication such as Rogaine (minoxidil) and Propecia (finasteride), have made real contributions toward stopping and even reversing hair loss.
During the late 70’s and early 80’s it was discovered that minoxidil, used as a heart medication, had hair growing side effects. Minoxidil was tested for use as a topical scalp treatment for hair loss and proved to inhibit hair loss in many test subjects.
It has proven to be effective to some degree in slowing the hair loss process. For a minority of people it can even grow back lost hairs in the crown area (back of the head). However, Rogaine (minoxidil) does not slow or reverse the balding process in the frontal hairline area.
Rogaine is typically applied topically on the scalp twice a day, morning and evening. But once usage is discontinued the hair loss which had been inhibited will resume and the hair that was saved will be lost.
Rogaine originally required a prescription, but in 1995, it became available in 2% strength Rogaine over-the-counter. Today, men and women can buy 5% strength lotion over-the-counter as Rogaine or as generic minoxidil.
To date Rogaine (minoxidil) and Propecia (finasteride)are the only hair loss medications with FDA approval. Propecia’s active ingredient, finasteride, was originally used to treat enlarged prostate glands. It was discovered that, like minoxidil, it had the “side effect” of stopping male pattern baldness and for some even regrowing hair.
Propecia is taken as a pill once daily and acts to inhibit the body’s ability to create dyhydrotestosterone or “DHT”. DHT acts as the active ingredient or catalyst in the balding process.
Rogaine and Propecia
The 90’s brought great advances in hair restoration, both surgical and non surgical. Now most people can realistically halt and reverse their hair loss with truly natural results.
In 1988 minoxidil, Rogaine, became the first hair loss medication to be approved by the FDA for the treatment of hair loss.
In 1998 the FDA approved Propecia for the treatment of hair loss. Propecia (finasteride) should NOT be taken by woman or children for any reason.
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Dr. Vladimir Panine
Dr. Vladimir Panine
Dr. Vladimir Panine and his experienced staff perform high quality follicular unit hair transplant surgery with excellent results -
Dr. Bessam Farjo
Dr. Bessam Farjo
The Farjo Hair Institute is a family run clinic solely devoted to performing excellent follicular unit hair transplantation in Manchester and London. -
The Psychology of Hair Loss
Long ago, a full head of hair was valued as a means of protection, heat retention, and camouflage.
Today we value hair for other reasons. Whether we admit it or not, good hair still is associated with power, virility and youth.
Such associations date back to ancient times. Remember the story of Samson and Delilah? When Delilah cut Samson’s long hair he lost his power.
"And Delilah made him sleep on her knees; and she called for a man, and she caused him to shave off the seven locks of Samson’s head. . . and his strength went from him."(Judges 16:19)
As “enlightened” as we are today, stereotypes associated with hair loss persist. The bald or balding are sometimes passed over and teased at work, in the media, and in the social scene. The media idolizes the young and the attractive and often lampoons the bald or balding.Of course, it’s not fair. But at least losing your hair is not health threatening. However, it can result in various psychological and emotional issues. These include insecurity, isolation, panic, a sense of loss, and even depression. But let’s first look at the role of hair (and the lack of it) in our society.How is Hair Loss seen by Society? So why does something as superficial as hair seem so important to so many men and women? Studies have shown that hair is a symbol of social, professional, cultural, and/or religious affiliations. Good hair implies power, virility, strength and youth.
Studies reveal how baldness is perceived.In a study done in 1971, a picture of one person was distributed to 60 people. But each picture had been altered by a commercial artist to reflect a non bald, balding, or bald condition. The results revealed some negative stereotypes.
When the person was shown with a balding head of hair he was rated as weak, dull, and inactive. This same person with a bald head of hair was rated as unkind, bad, and ugly. Yet this same person with a full head of hair was rated as handsome, virile, strong, active, and sharp.
Today, more than 30 years later, it is hard to know if things have really changed. But maybe some of these tired negative stereotypes about being bald are starting to change, at least in the media.
Today, bald NYPD Blue's -Dennis Franz, a multiple Emmy Award-winner, is considered a sex symbol.
As is Tony Soprano of the popular HBO TV show the Sopranos.
And, of course, let’s not forget Telly Savalas of the 70’s TV show Kojak who was once voted by People magazine as the “sexiest man alive.”
Studies about Baldness and Self Esteem
Those who are bald or balding are generally thought of as older, weaker, and more ineffectual, both in the work world and on the social scene.
According to a 1995 article in the “British Journal of Psychology,” balding men have been found to have lower levels of self-esteem than their peers, are less sociable, suffer more from depression,and are less likely to succeed in life.
Hair loss, especially when first occurring, can lead to rash decisions. So it is important to slow down and look at the many viable options that are available for dealing successfully with hair loss.
Our Hair Treatments section offers in-depth information on many viable treatments.
1992, researchers from the Old Dominion University in Norfolk, Virginia surveyed 145 balding men and found that 84% were preoccupied with baldness.
Their responses showed that they were filled with self-consciousness and helplessness. They were also envious of men with full heads of hair.
Additional research indicated that single men and woman who had begun losing hair in their early twenties were more likely to suffer from extremely low self-esteem.
Hair loss often creates emotional distress.
Loosing your hair can be disturbing, especially if you're a young man or woman. This unwanted loss forces those afflicted to face new issues, such as the perceived loss of youth and sexual attractiveness.
It's common for young people who are balding to have feelings of isolation. They may feel uncomfortable among their peers and in public. Young people with hair loss often lose their confidence and may also become less productive at work.
For older people hair loss is often just one more sign that they're reaching middle or old age. It may prompt them to question the direction of their lives or fear that their lives are closer to the end than the beginning. This can result in a sense of loss, insecurity, or even depression.
And as bad as men have it, hair loss can be even worse for women. Balding women must deal not only with the thought of aging, but also that they may not be considered attractive.
Coming to terms with hair loss.
Yes, hair loss can be disturbing. But there are many effective options available to you, ranging from hair loss drugs that often halt thinning to restoring the hair you’ve lost with surgical hair restoration.
However, prior to choosing a hair loss treatment, it is wise to deal with the psychological effects of hair loss.
Hair loss at any age, while not painful or dangerous, can cause emotional damage and distress.
Finding support and advice to cope with hair loss.
You can find support and share ideas and advice privately with other hair loss sufferers by reading and posting on our popular hair loss discussion forum.
By sharing with others you will realize that others share your same concerns and feelings about going bald. You will also learn about what hair loss treatments actually work or not from those who have already tried them.
Find a "Hair Loss Mentor" for - one on one - support and guidance.
In addition to our discussion forum, you can also view Hair Loss Weblogs created by actual hair restoration patients. These blogs contain photos journals documenting the person's hair restoration. Often you can correspond with these blog authors by email.
If you have a hair loss question please post it on our Hair Loss Q & A Blog. This blog can also be searched for dozens of answers on many hair restoration topics.
Empowering yourself with information and sharing your feelings and concerns will also make you feel much more in control of your hair loss. Then, if and when you finally do choose a hair loss treatment option, you will feel much more confident in your decision.
Many who once were preoccupied by their hair loss find a solution and move on in life, sometimes with a "new lease on life". While others choose to remain bald and simply accept it.
The choice is yours to make. This site is dedicated to helping you successfully resolve your hair loss issue on the inside as well as on the outside.
The disturbing truth about hair loss
In 1999, the psychological impact of hair loss, as well as its leading treatments, was the subject of the American Academy of Dermatology's summer scientific meeting in New York. At this meeting it was revealed that there were direct links between androgenetic alopecia (male and female pattern baldness) and personality disorders in those afflicted.
In one study of 116 subjects with hair loss it was determined that 76.3% of the participants had at least one actual personality disorder. This was an extremely high rate of disorder compared to the much lower rate of 10% of the general public suffering from personality disorders.
Another study showed that twice as many women than men with hair loss rated themselves as “very” or “extremely” upset about their hair loss.
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Kevis 8 Hair Loss Treatment Product Review
Is it Effective in Treating Baldness?Hair loss suffering men and women are always seeking new and credible treatments and with good reason. Medical science is still years from producing a true hair loss cure and current treatment options are vastly limited. Women with hair loss have even fewer options than their balding male counterparts when it comes to proven, non-surgical hair loss treatments. Additionally, there is no shortage of cunning charlatans waiting to take advantage of the unwary consumer. Thus, when a new product like Kevis Hair Rejuvenation Formula comes along claiming to be a “permanent” solution and “the most successful and potent hair loss treatment on the planet”, potential customers would be wise to remain skeptical.
Kevis hair loss treatment is not an entirely new solution. In fact, their website states that it has been sold throughout Europe and Asia for over 25 years but has only been available in the United States for 15 years. This is simply the 8th generation of the formula; hence their new name Kevis 8. But how can such an impressive treatment exist for 10 years yet remain virtually unknown to roughly 70 million balding American men and women? What’s even more surprising is that Kevis claims that published clinical studies give this solution for baldness an average success rate of 92%. So why are so many people still seeking viable hair loss treatments today?
Kevis 8 is a drug-free topical lotion developed and manufactured by Italian pharmaceutical company, Farmaka, and distributed by Kevis Rejuvenation Programs in North and South America and by Pfizer in Europe and Asia. As such, it does not come under the regulatory supervision of the United States Food and Drug Administration (FDA). It is applied directly to the scalp and can be used by both men and women. Ingredients are listed as:
Water, SD Alcohol 40-c+SD Alcohol 3-c, Propylene Glycol, Hydrolized Glycosaminoglycans (Thioglycoran), Panthenol, Sorbic Acid, Methylparaben, Hyaluronic Acid (H.U.C.P.), Thurfylnicotinate HCL, Propylparaben, Sodium Hydroxide, Biotin, Fragrance.
H.U.C.P is a high concentrate of pharmaceutical grade hyaluronic acid which purportedly aids in the breakdown of accumulated DHT in the follicle and creates a binding effect in the follicle's receptor sites preventing further DHT buildup. Kevis also lists the ingredient Tricozyme™. Tricozyme is a protein enzyme that they claim attaches itself to free-floating DHT molecules rendering them “inactive and inoperable”.
Kevis claims that results from using their product are “permanent”. Once hair follicles are protected from the effects of DHT they will remain DHT resistant for life. Thus, their claim is that once the desired result is reached, there is no need to continue using Kevis. This is a hefty claim considering all other non-surgical balding solutions are required to be used for life in order to experienced continued benefits.
In an effort to demonstrate its efficacy, Kevis provides complete, downloadable copies of seven clinical studies conducted by various institutions in France and Italy and provides summaries of each. They also offer several before and after photos (including those of company founder and President Brian Reichenberg) and written testimonials. What seem to be conspicuously missing are references to third-party studies and publications in peer reviewed journals. Without these critical components it’s impossible to verify the company’s hair growth claims.
Balding men and women may want to stick with clinically proven and FDA approved medical hair loss treatments. For men those treatments are Rogaine (minoxidil) and Propecia (finasteride). Rogaine is also approved for use by females. However, women should not ingest or even come in contact with finasteride due to the risk of specific birth defects. Men and women who are unable or unwilling to use these drugs can find credible alternatives.
When it comes to purchasing and using hair loss treatments, there is much more at stake than your hard earned money. Dedicating months or years to ineffective treatments may result in the unnecessary loss of valuable and irreplaceable hair follicles.