Is this likely male pattern baldness, telogen effluvium, or DUPA? (Photos)

Question

I'm 25, and have noticed diffuse thinning all over my scalp that appeared seemingly over the course of just a few months this year. I'm not sure whether this is TE, given that I had significant stress/anxiety during the pandemic that has only now started to relent. I had a buzz cut on and off for the past 2 years, but I only noticed a thinner appearance this year when I grew out one again. I thought I noticed shedding last fall, which has since stopped, but not sure.

Christine M. Shaver, MD · Answer

Often when you can see thinning extend to the back/sides of the scalp then it is a sign of DUPA. Classic male pattern baldness should not extend to the donor region. DUPA can be verified by looking for the presence of miniaturized hairs in these regions with a dermatoscope. TE shedding needs diagnosis with a positive hair pull test - the hair will self resolve and return within 1-2 years of resolution of the stressor. DUPA will not self-resolve and treatment with finasteride is often the most effective FDA-approved treatment.

Jeff Donovan, MD, PhD · Answer

Thanks for sharing this scenario. It’s too early to jump to conclusions without some further work up and testing. There are really three questions here that your doctor needs to help you with (once a good scalp examination is done and once your blood tests come back: 1) is the androgenetic alopecia alone 2) is the telogen effluvium alone 3) is this both AGA and TE? I don’t think we are dealing with any other question but of course a really good history is essential here too. Nearly 50 % of the population had COVID in the last 6-9 month and 10-50 % of those have experienced shedding. So it will be essential to review your story. DUPA does not come on “suddenly “ - it’s a slow process. Many males with a story like this have both AGA and TE so it’s more a matter of figuring out which of thr above three scenarios are present. You’ll need blood tests too but the exact ones you will need will depend on your full story. CBC, TSH, ferritin, CRP are probably worthwhile but many others might be added depending on your story. Keep taking photos.

Samer Muala, MD - Account Suspended · Answer

It does look a bit diffuse to me- but regardless I think the right thing to do would be to get a work up with lab and hair analysis- start a regimen of laser cap, prescription topicals, and prescription meds and reevaluate.  I am seeing more of this type of hair loss on my online treatment platform.

Is this likely male pattern baldness, telogen effluvium, or DUPA? (Photos)

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Is this likely male pattern baldness, telogen effluvium, or DUPA? (Photos)

Answers (3)

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Everything you need to know about Hair Loss Treatment

Our mission is to create a world where every investment in modern beauty is Worth It.