Do I have retrograde alopecia or DUPA? What is the best treatment option for me? (photos)

Question

22M. Over the past 2 years I have noticed some gradual thinning of my hair, but I recently went for a haircut a month ago and noticed significant thinning on the top, sides and crown. However my hairline is not really receding. What is my best treatment option for me? How severe is the loss currently and how quickly can it spread? My father is not balding, my moms dad started balding in his late 20s.

Jason Emer, MD · Answer

Thank you for your question, This needs an in-person evaluation. I suggest seeing a hair loss expert now to evaluate and go over your condition and provide you information about your best treatment options. There are great non-invasive options like prp/progesterone and/or hair transplantation. See an expert. Best, Dr. Emer

Donovan Rosas, MD · Answer

For both patterned and un-patterned hair loss...the treatment options are the same. There are numerous options available.Hair restoration is like a train...there are many cars and they are all headed in the same direction. The closer you are to the engine the faster you will reach your destination (i.e. the caboose is the last t pull in).
There are a number of modalities available ranging from supplements, topical therapies, medical therapy (Rogaine/Propecia) and PRP +/- light therapy.
Patients may try one intervention at a time beginning with the least involved and add or replace as they see results. Each has positives and negatives and not all will be equally effective.
Hair grafting is the final and most definitive solution, however this should be delayed until you have reached a stable hair pattern. This is due to the fact that the grafted hair is permanent and if you have not reached a stable pattern you can expect further losses and the need for more grafting to avoid the appearance of a double hairline (grafted hairline followed by losses and the receding natural hairline).
As always, discuss your concern with a board certified plastic surgeon (ABPS) with experience in hair restoration.
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
RealSelf Hall of Fame

Jeff Rapaport, MD · Answer

All of the options for treating androgenic alopecia are afforded a DUPA patient except for hair transplantation. Minoxidil, oral or topical, finasteride, PRP, nutraceuticals and low level laser are helpful. Jeff Rapaport MD FAADRealself All-star

Matt Tahsini, MD · Answer

Hello and thank you for your question. You need to be seen by a hair loss expert in order to determine what’s going on with your hair. Once you get a diagnosis you can plan your path forward. I wish you the best.

David Perez-Meza, MD, FISHRS · Answer

Great question. I won't recommend any treatment at the moment until you are seen for a local hair loss specialist. You need a detailed scalp and general evaluation of your case, it is critical to find out your hair loss cause and the best treatment option(s). God luck.

Ed Breazeale, Jr., MD · Answer

Hello and thank you for your question. If you just started noticing the thinning and hair loss it might be a good idea to look into PRP treatments to the scalp. This procedure often accompanied with some sort of regular scalp stimulation in encourage blood flow is beneficial to individuals who notice the shedding or thinning early. I would suggest your setting up a consultation with a provider in your area to discuss what options are best for you. Good luck to you!

William Rassman, MD (retired) · Answer

The diagnosis of DUPA (Diffuse Unpatterned Alopecia) is made with a high powered microscopic view of your donor area. This is important because if you do have DUPA it will impact everything about your hair for the future.  DUPA is very rare.

Do I have retrograde alopecia or DUPA? What is the best treatment option for me? (photos)

Answers (7)

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