Category: Hair Diseases

First of all i would like to take this time to say that this is the most helpful internet site about regarding hairloss.

My question is that i have began receding and thinning badly on the sides of my hair. From the side burn to just above my ear. My hair on top is thick and i am slightly receding at the corners, but at the side of my hair it is getting extremely worse quickly. why is this? what options do i have?

This is a good situation for mapping out your miniaturization. This will put numbers to what you are observing. A good doctor will know how to do this for you.

If you are thinning only on the sides, something that I have rarely seen, it’s often associated with diffuse unpatterned alopecia (DUPA).

Dr. Rassman,
Some time back I made the following posting and your hunch turns out to be right! I went to see a hair loss specialist (on my own as my physician tends to be dismissive). She did a biopsy and the results came back indicating alopecia areata. She recommended that I see a dermatologist. When I had the results in hand, only then did I tell my physician. My physician said he would refer me to dermatologist but the problem is there so few in our city that it takes months to get an appointment. Even then, preference is given to patients with more severe conditions.

I am wondering what I can do in the meantime. It seems my hairloss area is growing. The funny thing is that it looks somewhat like mpb. Initially the hairloss was visible only on the front right side just behind the hairline and then progressed towards the hairline and further back. The left sides is also catching up.

I’m really stressed out about this as my head does look good with short hair.

Treatment options are limited for alopecia areata, but a great starting point is the National Alopecia Areata Foundation. I wish I could offer more, but at this time you should see the dermatologist… and if it takes too long for an appointment, ask your doctor for another referral to someone that can get you in sooner.

Good luck to you!

Snippet from the article:

Matt Kelley was 38 when he first noticed a round, hairless spot in his beard. Within six weeks, every inch of his body that once had hair — including his eyebrows, eyelashes, arms and head — was completely bald.

“It was like a forest fire of hair loss,” Mr. Kelley said.

Mr. Kelley, now 43, has alopecia areata, an autoimmune disease that causes the body to attack its own hair follicles. Alopecia, which does not include normal male-pattern baldness, affects nearly 2 percent of the global population and has no universally effective treatment. Its progression is unpredictable and can range from a few bald patches to a completely hairless scalp to the loss of every hair on a person’s body — known as alopecia universalis. Sometimes the hair regrows, sometimes it does not, and sometimes it grows in only to fall out again years later.

Read the full story at the NY Times — A ‘Forest Fire of Hair Loss,’ and Its Scars

The article discusses how quickly this disease wiped out all of this man’s hair, the impact it had on his life, and the treatments he’s tried. The recent alopecia areata gene discoveries that were announced earlier this month has brought about renewed hope for a cure or at least a reliable treatment for those with this disease.

I have been diagnosed with Pityriasis lichenoides chronica which I have had since I was 15. About the same time my hair started thinning. I am now in my mid 30s and I have general thinning (no hairline recession) from the crown to the front. Both sides and the back of my head is fully thick. I have started propecia and minoxidil.

Is there any connection between the PLC and my hair loss?

I have no personal experience with pityriasis lichenoides chronica (PLC), but as I understand it, there’s not much known about the condition. How it relates to hair loss is unclear. For those readers that are curious, PLC “is characterised by the gradual development of symptomless, small, scaling papules that spontaneously flatten and regress over a period of weeks” (source: DermNet NZ).

What I do know is that the most common cause of hair loss in men is genetic male pattern baldness (MPB). It occurs in a pattern from crown to front as you describe, leaving the hair on the sides and back “fully thick”, as you also describe. It could be possible that you have PLC along with MPB and the two are unrelated.

It seems you need a good diagnosis and you cannot get that here on the Internet. You need to find a physician who can examine you and give you his assessment. A miniaturization study may be helpful as well and may point to the association of genetic male patterned hair loss if that is also present.

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I have been losing hair since I was about 17 (I am now 23), and I’m confused as my hair loss seems to have characteristics of both DUPA and typical MPB.

For example, I have a receding hairline and a small bald spot at the vertex – typical of MPB. However, I also have general thinning on the crown, forelock and down the sides and back of my head. Is it possible to have a receding hairline with DUPA? I was under the impression men with this kind of hair loss retained their hairlines.

If you have the gene for male pattern baldness (MPB), the expression of the gene will dictate when the hair loss starts and which balding pattern that you will evolve into. In most people, the frontal loss starts at the leading edge of the frontal hairline, but a few people will keep their frontal hairline while they lose the hair behind it. When it comes to those with diffuse unpatterned alopecia (DUPA), the loss of the hairline as you describe is possible.

Here’s an excerpt from a paper published in 1997 referring to DUPA that may clarify: Diffuse Unpatterned Alopecia patients have a similar progression of balding as the DPA [diffuse patterned alopecia] patient except that the progression is often more rapid and will more likely eventuate in a “horseshoe pattern” resembling the Norwood class VII, except that in contrast to the Norwood VII, the DUPA “horseshoe” can look almost “transparent” due to the low density.

The hair on the sides and in the back of the head (a 3 inch high part of the scalp that starts at the body prominence of the skull aka the “horseshoe pattern” mentioned above) is looked at as permanent hair in most men. In the diagnosis of DUPA, this permanent zone has miniaturized hair in excess of 20%. The higher the miniaturized hair count in the permanent zone, the more difficult it will be to get enough good healthy donor hair for a hair transplant.

Women have what looks like DUPA in that same area and also often throughout the head. This makes most affected balding women poor candidates for hair transplantation.