• Diffuse Unpatterned Alopecia (DUPA)

    Diffuse Unpatterned Alopecia

    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.

  • Jerry E. Cooley, MD

    Dr. Jerry Cooley
    Dr. Jerry Cooley
    Dr. Jerry Cooley and his staff were early adapters of using microscopes to do excellent all follicular unit hair transplantation.
  • FUE – a new way of doing Follicular Unit Hair Transplantation

    FUE – a new way of doing Follicular Unit Hair Transplantation

    Follicular unit extraction is a minimally invasive procedure for performing follicular unit hair transplantation. However, unlike the predominant follicular unit transplant procedure, in which a strip of donor tissue is removed and dissected under magnification, the FUE procedure uses a small punch to extract each follicular unit one by one.

    Both the strip excision and FUE procedures create 1, 2, 3, and 4 hair follicular unit grafts that are then transplanted into the balding area in the same manner. The primary difference between these two procedures is the technique used to harvest the follicular unit grafts.

    Comparing the Strip Excision procedure to the Extraction (FUE) procedure

    The common strip excision method of performing follicular unit hair transplantation involves surgically excising a thin horizontal strip of bald resistant skin from the donor area.

    Strip Excision Procedure 

    Donor strip being excised
    Donor strip being excised

     

    Incision sutured together
    Incision sutured together

     

    Hair combed down after suturing
    Hair combed down after suturing

     

    This donor area is then sutured together. These sutures (either stitches or staples) are then typically removed about ten days after surgery. Some physicians use dissolvable sutures so that no removal is needed.

     

    Patient’s donor area 2 months after surgery
    Patient’s donor area 2 months after surgery

     

    Once this linear incision is fully healed the patient is left with a thin horizontal scar in the back of the head. This scar is typically hard to detect since the surrounding hair conceals it, even when the hair is cut short.

    To view a video of an actual strip excision surgery.

    How the FUE Procedure is performed

    With the Follicular Unit Extraction or FUE procedure 1, 2, 3, and 4 hair follicular unit grafts are carefully extracted one at a time using a tiny punch of one millimeter or less. Often the surgeon requires the patient to buzz cut a portion of their donor area so that they are able to see the patient’s scalp.

    The follicular units are extracted
    The follicular units are extracted

     

    The follicular units are extracted by placing the punch around a single follicular unit and cutting a small circle through the skin around that follicular unit. The follicular unit is then gently pulled up and away from the loose tissue underneath the skin.

    The small hole left behind after the follicle is extracted then heals over the following week. Normally this small round incision contracts as it heals making the resulting round scar smaller than the size of the 1mm punch that made the incision. The FUE patient ultimately ends up with hundreds of small round white scars, which are normally not detectable once the patient’s hair grows out.View a video of an actual FUE surgery.

    To Extract or to Excise, that is the question.

    Advocates for the relatively new FUE procedure claim that this procedure produces less noticeable scarring and no tightness or numbness in the donor area since no donor tissue has been pulled together and sutured. Many patients and physicians find the claim that FUE produces less visible scarring to be debatable.

    Some physicians and patients also have concerns about the relatively new FUE procedure, such as the lack of formal studies regarding the percentage of follicles that may or may not be transected during the sight unseen extraction process.

    In addition, since the physician must personally extract all follicles, one by one, the FUE procedure is very physician dependent and thus very expensive. The FUE procedure also requires considerably more time in surgery to move a given amount of hair to the balding area.

    The standard strip excision procedure has the advantage of utilizing a collaborative team to carefully create the grafts once the donor tissue is removed in a strip. This collaborative approach enables a well trained staff to do sessions of 2,000 to 3,000 all follicular unit grafts in a single day. This team approach enables a patient to get a much larger number of grafts/hairs in one sitting at a much lower cost per hair than with the FUE procedure.

    However, some believe that despite being relatively costly the FUE procedure may be appropriate for patients who have very limited elasticity in their donor area or who only need a small number of grafts.

  • Dr. Taleb Barghouthi

    Dr. Taleb Barghouthi
    Dr. Taleb Barghouthi
    Dr. Barghouthi performs Ultra Refined Follicular Unit Extraction (FUE) and Follicular Unit Strip Surgery (FUSS) with excellent results. He and his staff can perform extensive mega sessions with dense natural results.
  • Thomas Chung Wai Nakatsui, MD

    Dr. Thomas Nakatsui
    Dr. Thomas Nakatsui
    Dr. Nakatsui performs large sessions of ultra refined follicular units using the lateral slit technique with extremely natural results.
  • Child Birth

    Child Birth

    Childbirth may result in hair loss. It's common for many women to notice hair loss about 3 months after they've had a baby. This too, is caused by hormones. But this is not something to worry about. You see, during pregnancy, hair that normally falls out is kept in by high levels of hormones. Once the hormones have returned to pre-pregnancy levels, this extra hair falls out. The normal cycle of hair growth and loss then begins again.

  • Find a Hair Restoration Treatment and Physician

    Find a Hair Restoration Treatment and Physician

    Reviewed by Hundreds of Patients!

    This Learning Center offers in-depth reviews of hair loss treatments and the leading physicians who provide them. Today, there are treatments that can stop or even reverse hair loss. Hair transplant surgery, when done right, can now produce results so natural that even hair stylists cannot spot them.

    But it is critical to choose the right hair loss treatment and hair restoration physician, since the skill, talent, and experience of physicians vary widely, as do their results.

      Find a Coalition Physician
  • Hair Transplant Cost

    Hair Transplant Cost

    Today hair transplant costs are vastly better value, than they did just a few years ago. Increased competition combined with the increased ability of a specialized clinic to produce large sessions of follicular units at reduced hair transplant costs and has resulted in patients getting vastly better results and increased density at lower prices.

    Just a few years ago it was not unusual for a clinic to charge as much as $15 US per graft, while providing patients with only small sessions of a few hundred grafts that achieved limited density and fullness.

    Today hair restoration clinics typically provide free no obligation consultations, with surgical sessions priced either per graft or by the session. Hair transplant costs typically cost between $3.00 to $8.00 per graft, with $5 to $6 per graft being about average.

    It is normal for the price per graft to drop as the size of the surgical session increases. Many clinics will offer a reduced rate per graft once a certain surgical session size (i.e. 1,000 or 2,000 grafts) is exceeded.

    Comparing the costs of various hair loss treatments

    Price options

    Although hair transplant surgery is not inexpensive, it can be the best hair restoration value given that the results are natural and last a life time. The cost of non surgical solutions like a hair system or hair loss medications can exceed the cost of hair restoration surgery when the long term costs are compared.

    For example – A quality custom hair replacement system on average costs $1,200 and needs to be replaced about once a year. In addition, a hair replacement system requires regular upkeep and reattachment each every 5 to 6 weeks at about $75 per visit or $675 per year.

    Hair Piece, or Surgery

     

    Thus the cost of buying and maintaining quality hair replacement systems over 15 years is approximately $28,125.00 ($1,200 plus $675 in annual upkeep = $1,875 x 15 years = $28,125.00). This total cost well exceeds the typical cost of surgical hair restoration.

    Note - Of course the cheapest option is shaving your head with an actual net saving due to no expense for shampoos, conditioners, combs, brushes, or hair stylist.

    Consult a physician for an estimate

    Our member physicians price their procedures independently. So your final cost will depend on who you select and how much hair restoration you will need to be satisfied.

    To do a free consult with one of our quality member physicians to get an estimated cost of restoring your hair visit our member physicians’ area.

  • Surgical Hair Restoration - View our procedures in detail

    Surgical Hair Restoration

    Our physician members perform a very refined hair transplant procedure called "Follicular Unit Hair Transplantation". Today there are two methods for doing this procedure. They differ only in the methods used to harvest and prepare the grafts.

    Follicular Unit Extraction Video is provided courtesy of Dr. Alan Bauman.

     

     

    How the follicular unit extraction (FUE) hair transplant procedure is different than standard strip excision hair transplant surgery.

     

     

    How the minimally invasive hair transplant procedure known as Follicular Unit Extraction or FUE is performed.

     

     

    How follicular unit grafts are created under microscopic dissection and then placed into tiny incisions in the balding areas.

  • Tricomin Follicle Therapy Spray, Shampoo and Conditioner

    Tricomin hair loss treatment

    Tricomin pack

    Tricomin is an all natural hair loss treatment designed for both men and women with thinning hair to stimulate hair regrowth and improve the appearance of thinning hair. It can also be used in conjunction with with Rogainehair regrowth treatment.

    Tricomin Solution Follicle Therapy Spray combines the benefits of the Triamino Copper Nutritional Complex with an exceptional leave-in conditioner. The therapy spray enriches your hair and scalp with a unique blend of mineral and body-building ingredients and essential amino acids. Spraying the therapy spray liberally after shampooing daily will condition and treat your hair and scalp. It's recommended to apply this product to damp or dry hair.

    The Tricomin Revitalizing Shampoo stimulates and restores health, structure, and vitality to thinning, fine, and damaged hair. It's recommended to use the Revitalizing Shampoo daily, gently massaging it into moistened hair scalp, leaving on for 3 to 5 minutes before rinsing. A second application may be made if desired.
    The Restructuring Conditioner uses a unique moisture and nutrient-rich framework to help restore your hair's natural mineral and protein balance. This conditioner helps to add structure and body onto thinning and/or damaged hair.

    For best results, use all three Tricomin products in conjunction with one another. All 3 Tricomin products is called the Tricomin TricoPak.

    How It Works:

    Al three Tricomin products contain the active ingredient copper peptides. Scientific evidence suggests that copper peptides can shorten the shedding (telogen) phase and elongate the growth (anagen) phase of the follicles. Partial FDA trials showed Tricomin products' effectiveness in promoting new hair growth.

    Developing Realistic Expectations:

    Tricomin copper peptide technology may provide marginal benefit to men and women with thinning hair. To date, only surgical hair restoration is proven to grow hair in completely bald areas.  You are invited to have a free virtual consultation with one of our prescreened hair restoration physicians.

    Ingredients

    Tricomin Follicle Therapy Spray:  Purified Water, SD Alcohol 40B, Amodimethicone, Nonoxynol-10, Panthenol, Polyquaternium-11, Polysorbate 60, Tallowtrimonium Chloride, Citric Acid, Dimethyl Lauramine Isostearate, Linoleamidopropyl Ethyl Dimonium Ethosulfate, Triamino Copper Nutritional Complex (Alanine/Histidine/Lysine Polypetide Copper HCl), Methylparaben, Benzethonium Chloride, Menthol, FD&C Blue #1.

    Tricomin Revitalizing Shampoo: Purified Water, Sodium Laureth Sulfate, Disodium Cocoamphodiacetate, Cocomidopropyl Betaine, Ceteth-16, Glycerin, Laneth-16, Oleth-16, Steareth-16, PEG-75 Lanolin, Sodium Chloride, Triamino Copper Nutritional Complex (Alanine/Histidine/Lysine Polypetide Copper HCl), Citric Acid, Diazolidinyl Urea, Hydrolyzed Keratin, Panthenol, Methylparaben, Fragrance, Propylparaben, Peppermint Oil, D&C Red #33, FD&C Blue #1.

    Tricomin Restructuring Conditioner: Purified Water, Glyceryl Stearate, PEG-100 Stearate, Stearamidopropyl Dimethylamine, Cetyl Alcohol, Propylene Glycol, Stearyl Alcohol, Dimethylamine, Triamino Copper Nutritional Complex (Alanine/Histidine/Lysine Polypetide Copper HCl), Hydroxyethylcellulose, Panthenol, Aloe Vera Gel, Soydimonium Hydroxypropyl Hydroxylyzed Wheat Protein, Hydroxylyzed Keratin, Citric Acid, Methylparaben, Fragrance, Disodium EDTA, Propylparaben, Peppermint Oil, Tocopheryl Acetate, Cholecalciferol, Retinyl Palmitate, Vegetable Oil, FD&C Blue #1, D&C Red #33.