This 24 year old man presented to my office today with hair falling out. He has been on Propecia for 9 months. Upon examination I made the following observations:
- His hair density was low all over the scalp.
- He is losing substantial amount of neck hair disproportionally to other hair.
- He has miniaturization in the donor area to about 30%.
I am concerned that this young man has Diffuse Unpatterned Alopecia (DUPA) and that he may lose some of his donor hair in the future. This condition is an absolute contraindication for hair transplants and at the age of 24, what is the rush? As you can see from the photo below, his hair looks full, but just thinner in the frontal area. I told him that he needs to be followed closely over the next few years and that his Propecia is the correct medication to try to hold his condition at bay. Many other doctors with less scruples might transplant him and if they did, he might accelerate his balding pattern in the recipient and the donor area and a see-through look could develop from the sides. The last doctor he visited never mapped out his hair for miniaturization and as such would have missed the diagnosis.
Click the photo to enlarge. Note that the miniaturized hair count is about 30% from the donor area.
Can you please add more pictures so we can see the side views and back views of his head to see the donor area thinning?