Month: July 2009

I have a question regarding Diffuse Patterned Alopecia (DPA). My hair loss follows this diffuse pattern, with no loss on sides and back. I was wondering is the success rate for DUA treatment with propecia the same as typical norwood pattern hair loss? Also does DPA typically progress more rapidly than norwood patterns?

If the sides and back are not miniaturized, then you may have a form of MPB, which in young men responds usually very well to Propecia (finasteride). Diffuse unpatterned alopecia (DUPA) usually does not respond to finasteride, but a rare few cases I have seen have gone against the grain and responded to lessen the amount of miniaturization, although some of it did remain. DUPA is essentially not treatable and we really do not understand what is happening in those who have it.

On the other hand, with diffuse patterned alopecia (DPA), this is a form of male patterned balding that is genetic and can be effectively treated with finasteride. The presentation is more generalized in the pattern of balding and rather than lose hair from the front to the back in a progressive manner, the hair loss is subtle and generalized, but ends up at the same point as if it were classic patterned balding.

Hello Dr.Rassman!

My question: When MPB starts, how long does it usually take for the hair loss to become noticeable? I am starting to lose hair/thin (only visible by me) and with MPB in my genes on both sides of the family, I am curious how long it will take for it to become apparent.

I’m sure there’s no exact answer for my question, but I assume there is an average time frame.

Thank you!

Male pattern baldness (MPB) can start with the onset of puberty, but it is not usually socially noticeable until more than 50% of your original hairs fall out. This can take many years. In general, for those who go completely bald (Norwood class 6 or 7 — see image at right) it can take 5 to 10 years, but there are always exceptions. For some men it can take 20 to even 30 years.

There is no general time frame that fits everyone. Maybe you should ask your family members who have MPB how long it took them to notice their hair loss.

I am in a pickle. My entire scalp and even my eyebrows are almost continuously itchy. This itching occurs especially often during physical activity where the body temp rises in the head. My hair has been shedding rapidly at the same time, specifically in the past few months. Hair has been pouring out of my head, but evenly throughout the scalp, making doctors skeptical of my concern. I have seen a number of doctors, none of them with advice other than propecia or rogaine. The itching has stumped them a well, causing me to be referred to a dermatologist, which cannot get me in until November.

Please let me know if you have heard of a similar case or if there is anything you would recommend. Thank you!

I am not sure how I can be of help if you have already seen a number of doctors. You are doing the right thing by seeing a dermatologist. Keep the appointment and let me know what you find.

Hair loss is mostly due to genetic causes in men. Do you see a particular pattern developing on your scalp? Generally, itchy scalp or skin may be a sign of infection (such as fungus, scabies, etc) / irritation (from chemicals, shampoos, soaps, etc). Your doctor (not me) can tell you if you have an infection.