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.
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.
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.
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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If you are going bald you should seriously consider hair loss medication treatments to halt or even reverse your hair loss. While there is no “Hair Loss Cure”, hair loss drugs like finasteride (Propecia) and dutasteride (Avodart) can often stop or even reverse alopecia areata in most people.
However, just like any other drug, Propecia is accompanied by a list of potential side effects, some of which have been more recently reported as potentially long term. You can read more about this in the "What About Side Effects" section further down this page.
Studies have shown that 80% of men using Propecia stopped or even reversed their hair loss to some degree. Preliminary clinical trials for Avodart appear even more effective than Propecia.
However, neither Propecia nor Avodart has been proven to restore hair in the frontal areas. For reasons yet unknown these drugs, along with Rogaine, only generally work in regrowing thinning hair in crown area of the scalp. Only hair transplant surgery has been successful in restoring hair in the frontal hairline area once it has been lost.
Propecia and Avodart are also less effective in growing hair in older men. These hair loss drugs work best for men who have been balding for less than five years.
Both Propecia and Avodart are not recommended for use by women or children.
It’s been found that these drugs can cause birth defects. More specifically, these birth defects may occur when large amounts of the drug are absorbed into the body during the period of foetal development.
Physicians advise pregnant women to not handle Propecia tablets, as this may harm male foetuses. But as of yet, there has not been a single reported case of birth defects caused by handling these tablets.
Furthermore, there’s also no evidence that pregnant women exposed to the semen of Propecia or Avodart patients will risk any birth defects.
Propecia and Avodart are also not advisable for men with liver disease or prostate cancer.
Often our member physicians will prescribe Propecia or Avodart to halt a patient’s hair loss and then restore the hair already lost with hair transplant surgery. These treatments in combination can work synergistically. The drugs work to halt the hair loss, while hair restoration surgery restores what was lost.
To get a prescription for Propecia or Avodart schedule a free no obligation consultation with any of our quality hair restoration physicians. Find a physician in your area.
Propecia and Avodart should be taken once a day. It has been found that after two years of treatment, Propecia effectively grows hair in about 66% of patients. Also, about 83% of the subjects receiving this treatment continue to maintain their existing hair after two years.
Propecia (Finasteride) was originally a drug called Proscar, which was used to treat and reduce men's prostate conditions such as benign prostatic hyperplasia (BPH).
Its parent company, Merck & Co., soon realized that the drug had a unique side effect - it grew hair on bald men's heads.
In December 22, 1997 the FDA approved Propecia as a hair loss pill. Merck & Co. then marketed the drug as a hair loss treatment under the trade name of Propecia.
More recently Dutasteride, sold as Avodart, has generated interest as a promising new hair loss medication. Like finasteride (Propecia) it inhibits the creation of DHT and was originally developed as a treatment for men’s prostate condition.
However, unlike Propecia, Avodart inhibits the creation of both type one and type two 5 alpha reductase enzymes. Dutasteride has been shown to decrease levels of DHT by 90% after only two weeks, making it a more powerful and faster acting weapon against hair loss than Propecia (Finasteride).
Dutasteride is not yet FDA approved for the treatment of hair loss. However, some hair restoration physicians also prescribe it for the treatment of hair loss. Like Propecia, Avodart is not safe for women and children.
Losing your hair took time. So too will regrowing your hair using Propecia or Avodart. These drugs require patients to take the drug daily for at least three months before any obvious changes will be noticeable. Most physicians advise taking these drugs for a year before evaluating their effectiveness.
At this time, Propecia and Avodart are only available by prescription. Our member physicians are available to discuss these hair loss drugs with you and prescribe them if appropriate. To find a quality hair restoration physician in your area.
Aside from Propecia and Dutasteride, there are other treatment options (all topical) that may or may not work to block the effects of DHT on vulnerable hair follicles. These include Revivogen, Crinagen, Progesterone Creams, and Xandrox (a type of minoxidil). Other DHT Blockers
To learn more about these treatments, as well as all other topical options, visit our Topical Hair Loss Products and Treatments section.
Baldness is largely the result of dihydrotestosterone (DHT) interacting with those hair follicles that are genetically vulnerable to their effects.
DHT is essentially the active ingredient or catalyst for the hair loss process. DHT binds with the receptor sites of genetically vulnerable follicles and gradually degrades the follicles ability to produce healthy hair. This eventually results in baldness in the affected areas.
Hair loss drugs like Propecia or Avodart work by inhibiting the conversion of testosterone into dihydrotestosterone (DHT). By reducing the amount of DHT present in the scalp the hair loss process is slowed and in some cases even reversed.
Up until a couple of years ago, side effects when taking Propecia or Avodart were only considered temporary. However, over the last several years, many me have reported ongoing side effects from Propecia even after stopping treatment. This more permanent condition has become known as "Post Finasteride Syndrome" or (PFS). Side effects included but aren't limited to reduced semen production, a reduced libido and softer erections.
As a result, in April of 2012, the FDA mandated labeling changes to finasteride related products. Labeling changes to Propecia include "libido disorders, ejaculation disorders, and orgasm disorders that continued after discontinuation of the drug". Labeling changes to Proscar include "decreased libido that continued after discontinuation of the drug". Labeling changes to both Propecia and Proscar include "reports of male infertility and/or poor semen quality that normalized or improved after drug discontinuation".
While most men don't experience any side effects at all, it should be known that a small percentage of men may experience persistent side effects even after stopping treatment. Most men who experience side effects however, only experience them temporarily and stopping treatment makes them go away.
For a list of potential side effects and more information on Post Finasteride Syndrome", visit http://www.pfsfoundation.org/.
Hair Replacement systems, also known as hairpieces, hair replacements, hair systems or toupees, have improved over the past decade. Quality hair replacement systems are now refined in construction and light weight. For those with extensive baldness who require a full head of hair to be satisfied they offer a quick and nearly instant solution.
Hair systems are constructed of human hair or synthetic fiber. Recent advances have made the synthetic hair much more natural in appearance and texture.
A quality hair replacement system is specially constructed for an individual recipient. These systems are made of real hair, synthetic, or both. They're designed to attach to the head for an extended period ranging from 3-6 weeks, without ever being taken off. Visit Farrell Hair Systems for more information.
Hair systems can work for both men and women. In fact, more and more women are opting for hair systems over wigs, as they can be more comfortable and look more natural.
Typically clients first visit a hair salon for an evaluation. The extent of their hair loss is measured. They are given information including prices, maintenance, and future schedules. Usually, it takes several days for the system to be prepared, based on the client’s preferences.
While a person can get virtually any type of look, you are generally guided towards an option that looks more undetectable and realistic. These studios employ their own hair stylists to achieve ideal looks. Clients can visit these stylists for monthly haircuts or touch-ups.
With these hair systems, a fine mesh foundation is placed on the scalp's balding area and precisely cut to these dimensions. Later, real or synthetic hairs will be inserted into a foundation to create the "Hair System" or hair piece.
The foundations of the past were actually designed to be thicker and more durable. Fortunately, today's foundations are much thinner to make them undetectable. However, this thinness comes at a price, literally. The thinner a system the more delicate it will be and thus it will require being replaced more often.
Once completed, the hair system is attached to the client scalp using clips, weaving, and/or adhesive. The hair system is then styled to match your existing hair.
The stylist in the studios also remove the systems about once a month for maintenance, cleaning, and styling. During these adjustments a person can expect to have their hair system removed, their scalp thoroughly shampooed, and their hair cut. The hair system may also be touched up and or colored if needed.
It's crucial to carefully groom the hair system to maintain a natural appearance. With a quality system, a person can expect to continue doing all normal activities such as running, bicycling, and weightlifting.
However, hair systems typically require time, money, and effort to keep them looking their best. And some clients may feel some discomfort, as well as some insecurity that their hair system may be detected.
Hair replacement systems can be attached in a variety of ways. They can adhere to the skin, hair, or a combination of both.
When attached to existing hair this method can provide an extra sense of security for clients who enjoy active lifestyles. This type of attachment goes by names such as fusion, weaves, cabling, beading and bonding. Because this type of attachment depends on the rate of the hair's growth, the system must be reattached periodically.
Hair replacement systems can also be applied to bare skin. This can be performed in a variety of ways, such as waterproof and biologically safe glues as well as two-sided tape. However, while these glues and tapes are generally safe for the skin, it's possible to have an adverse reaction. For that reason you should tell the studio stylist of any discomfort.
It's also possible to have a hair system applied surgically. In this case, small skin grafts, known as "tunnel grafts", are taken from a donor site. These tunnel grafts are then formed into tiny loops and placed in the balding areas where the outer edges of the hair system will be attached. The edge of the hair system is then attached to these loops once they have grown into the scalp. Since the hair system is now attached to the scalp, rather than the existing hair that grows out over time, the hair system does not get progressively looser over time.
However, this method of attachment is not recommended due to possible complications such as skin infections.
If you're considering a hair attachment, you need to be aware of just how to locate the nearest studio, as well as what to look for in one.
Of course you can use the Yellow Pages or the Internet to locate a qualified studio. However, once you do locate one, it may be a good idea to check with the local Better Business Bureau for complaints against the company. It's usually only a problem if there have been multiple complaints against the company.
It's best to consider a hair attachment studio that specializes in non-surgical hair replacement systems. And once you do find an appropriate office, it's best to bring along a photograph showing your ideal look. Plus, try to meet with other clients who are wearing the hair system you may be considering.
It's also important to find out how a company handles potential client problems and complaints. Do they have money-back guarantees or trial periods? These are important questions to ask.
You may also want to check around with the American Hair Loss Council (AHLC), one of the leading groups governing hair loss. The AHLC can't endorse any individual firm. However, this organization supplies clients with a list of local AHLC specialists, known as the American Hair Loss Council Source Book. The specialist and studios on this list are all required to sign a statement that says they honor the group's code of ethics. This code is designed to protect consumers.
With hair loss treatments often being marketed without regulation or accountability, hair loss sufferers need credible information about legitimate treatments and the ethical physicians who provide them.
The Coalition of Independent Hair Restoration Physicians is a carefully selected group of skilled and ethical physicians who are united in providing patients with outstanding education and results.
Membership in the Coalition requires members to maintain a high degree of patient satisfaction. Members care for their patients knowing that their patients are free to post their experiences on the popular Hair Restoration Discussion Forum. On this open forum patients are free to critique physicians and to hold them accountable for their actions. This forum is run and moderated by hair restoration patients.
In such a transparent environment our members are held publicly accountable for their actions and results. Members who fail to meet the high technical and ethical membership standards set by the Coalition are removed from the group.
However, we ask that patients first give their physician the opportunity to satisfy their concerns privately before posting any public criticisms on the discussion forum.
If the issue is not resolved to the patient’s satisfaction they are encouraged to contact the Coalition by email to service at hairtransplantnetwork dot com
Member clinics also agree to open their clinics up to inspection. Many of these inspections have been reported on the Hair Restoration Discussion Forum. View some of these clinic visits.
The skill, technique and talent of hair restoration physicians vary widely, as do the end results. Only a minority of leading physicians provide truly state of the art hair restoration.
Coalition members are carefully reviewed and granted membership based strictly on their high level of integrity, skill, experience and ability to perform ultra refined follicular unit transplantation.
All Coalition members have made the investment in time and resources to perform a highly refined and difficult to perform state of the art procedure called “Ultra Refined Follicular Unit Hair Transplantation”.
While many surgeons now perform standard follicular unit grafting, only a minority have risen to the challenge of using very tiny incisions and grafts to achieve ultra refined results. This ultra refined procedure, while very demanding on the physician and staff, produces excellent results for the patient with optimal density and rapid healing. It also allows the patient to achieve their goal for fullness and density with a minimal number of surgical sessions.
To learn more about Ultra Refined Follicular Unit Hair Transplantation
A physician must meet the following requirements before being granted membership in the Coalition of Independent Hair Restoration Physicians:
Note - All members contribute dues to support our joint educational resources and services.
We are open to reviewing experienced surgeons for possible membership. Apply for membership as a physician.
Membership Selection Process
Physicians with a proven track record of providing excellent ultra refined follicular unit hair transplantation and who meet the Coalition’s membership criteria will be considered for membership.
In addition to reviewing the applicant physician’s credentials, technique and results, input from patients and current members of the Coalition will be considered prior to membership being granted.
