Dr. Matt Egan is a distinguished hair restoration surgeon based in the UK. Dr. Matt Egan's combination of surgical expertise, dedication to natural aesthetics, and personalized patient care make him a highly regarded choice for individuals seeking hair transplant procedures.
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.
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.
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.
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.
The most important decision in restoring your hair is the physician you choose. The skill, talent, and experience of hair restoration physicians vary widely, as do the end results. Who you choose will determine how natural and full your new hair will be for the rest of your life.
Since performing follicular unit hair transplantation is very demanding upon a clinic’s physician and staff only a minority of hair restoration clinics perform it successfully. Unfortunately, many clinics are still unwilling or unable to dedicate the time and resources required to master and perform this procedure successfully.
Therefore, those seeking only the most natural results need to be very selective. Keep in mind that in the United States any licensed physician can perform hair restoration surgery without any special certification or training. If you do not find an excellent hair restoration surgeon in your local area seriously consider traveling out of state to get your hair restored properly. After all, the results will last a lifetime.
Evaluating a potential hair restoration physician and clinic
How many years has the physician been dedicated to doing hair restoration?
How many hair restoration procedures does the surgeon perform in one day? Ideally the physician will be dedicated to working on you all day if you are doing a large mega session procedure.
Does the physician perform hair restoration surgery full time or predominantly? If not, the clinic may not have a staff that is experienced enough to successfully perform large sessions of all microscopically prepared Follicular Unit (FU) grafts.
What is the hair restoration surgeon's reputation among his or her peers?
Does the physician take a holistic approach to hair loss treatment and also offer advice or Rogaine?
What procedure does the clinic perform? Is it truly state of the art?
Does the physician use microscopes for the dissection of the donor tissue into 1, 2, 3, and 4 hair Follicular Unit (FU) grafts?
Large sessions of all microscopically prepared grafts are a team effort. But how "hands on" will your hair restoration surgeon be? Will he or she be making all the incisions in the graft recipient area, thus determining the design and hair direction of your transplanted hair? How involved will your surgeon be in the placing of the actual grafts?
Trust but Verify – Review Patient Results
Can the surgeon provide a list of names and phone numbers of patients willing to discuss their personal experiences? Patient testimonials will say a lot.
Can the surgeon provide at least one dozen sets of clinical "before" and "after" case photos for your review? Be sure the photos offer good clarity and detail and include "before" views as well as "after" views that allow for critical evaluation.
Verify claims by visiting online discussion forums and searching for previous posts regarding a hair transplant physician you are considering.
Consider our Quality Physicians
Our member physicians are carefully reviewed and granted membership in the Coalition based on their high level of ethics, skill, and the quality of their patient results.
Nioxin is an excellent product including both a shampoo and conditioner formulated specifically for men and women with thinning hair."> While neither the shampoo nor conditioner hasn't been proven to have any effects on DHT (the hormone responsible for male pattern baldness); Nioxin's ability to strengthen follicles and energize cellular activity can improve the overall health of your scalp and hair. Nioxin therefore may have the ability to delay the effects of hair loss. For best results, use both the shampoo (refered to as Nioxxin Shampoo Scalp Cleanser) and conditioner (referred to as Nioxin Scalp Therapy) in conjunction with one another.
Nioxin Scalp Cleanser's cooling properties refreshes and cools the scalp promoting maximum cleanliness and freshness. Because of this, Nioxin shampoo, especially when combined with the conditioner also significantly reduces scalp itchiness and tenderness after hair transplant surgeryin both the recipient and donor areas.
Nioxin Scalp Therapy is an excellent volumizing scalp and hair conditioner that moisturizes and improves your hairs' natural resilience, while promoting a healthy scalp environment for optimal hair growth. Nioxin Conditioner is the perfect conclusion to the Nioxin Shampoo Scalp Cleanser.
Nioxin Scalp Therapy's minty fresh cooling sensation literally refreshes and cools the scalp promoting maximum cleanliness and freshness. Because of this, Nioxin also significantly reduces scalp itchiness and tenderness after hair transplant surgery in both the recipient and donor areas.
We strongly recommend using Nizoral shampooevery 2 or 3 days in conjunction with Nioxin. Its active ingredient ketoconazoleat 2% concentration has proven to be a moderate DHT inhibitor and has growth properties approximately as effective as Rogaine2%.
Developing Realistic Expectations:
Men and women sometimes suffer from hair loss for different reasons. Thus, diagnosing its cause is necessary to facilitate and promote proper treatment.
The Nioxin product line is an excellent scalp and hair cleansing shampoo and conditioning therapy but is not proven to stop hair loss. Thus, we strongly recommend using Nioxin in conjunction with the "Big 3" (Propecia, Rogaine, and Nizoral.
Dr. Bijan Feriduni has been dedicated exclusively to advanced hair restoration since 1995 and now performs large sessions of ultra refined strip and FUE hair transplantation with outstanding results.
Dr. Ted Miln is performing refined follicular unit grafting with incredible density, with results that are undetectable from his patient's native hair.