dear doctor,
Im a male. I was wondering if you can get DUPA at a later age like mid 30s or is it something that your born with? thank you
I believe that diffuse unpatterned alopecia (DUPA) can appear at any age and there is probably a genetic predisposition to it. We do not know the cause of DUPA, but we assume it is like the female unpatterned hair loss… which we also do not understand.
About a month ago I noticed two spots of hair not growning on my face and then a week later another on my cheek. Now I have a small spot on the bad of my head missing hair also. My girlfriend thinks it’s because of stress. What do you think it is?
You need to see a good dermatologist. Amongst the things that the doctor will evaluate is the possibility of alopecia areata or ringworm (the two most common causes of what you are talking about). It is not reasonable to expect me to make a diagnosis over the internet from a few lines of description.
Hello, I am 18 years old and my hair is thinning rapidly(has been for about 10 months) and it is also receding, I have many pimples on my head and I am constantly squeezing them, I tried stopping for just today and they keep itching. Are the spots stopping my hair from growing? is squeezing them bad for my hair folicles? and do I have any symptoms of any bacterial infection?
Thanks very much
It is very clear that you need to see a doctor and be examined. You may have recurrent folliculitis (a type of infection of hair follicles). The internet is not a substitute for a good doctor.
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I have a condition that is called ‘cutis verticis gyrata’ where the scalp grows ridges or abnormal lines on the surface. I have had this condition for some time, but have never been concerned before because I have hair that covers the ridges in my head. I’m in the beginning stages of MPB, and have been taking propecia for about a month. I don’t know if my hair loss will ever be extensive enough to show the condition of my scalp, but it causes great concern because I do not want this to happen. I am 32 years old. Have you ever dealt with this issue before? I have read a little on the internet to try to see what people have done with this, but there is not much out there about it. I have read that it has been treated with scalp reduction, which sounds reasonable, but then what? Any ideas?
After receiving your email, I wrote to a group of well-respected doctors to inquire about experience in this area, and the general consensus was that this should not be treated surgically. Most of the doctors I wrote to were dermatologists who may have an aversion to scalp reductions in this situation. You need to be evaluated by a surgeon, perhaps a very specialized plastic surgeon who has experience doing this surgery in a patient with your diagnosis. Logically, scalp reductions should work, but I wouldn’t recommend that you be the first patient to attempt surgery to correct this condition.
If you are concerned about balding (which might make the appearance more detectable) then I strongly suggest a miniaturization study to see what degree of hair is at risk of falling out, followed up by a Master Plan. If I was your doctor, I would explore your options after you became my patient, but I simply cannot give you an in-depth answer as I have not examined your scalp or your hair.
Image from DermAtlas
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:
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.
i consult a doc he told me that i have a disease of lichen. one year ago black spot come on my head on different places.and i became bald on that places.now i have become mostly bald. could u suggest me what should i do now.and could u tell me can my hair comes back and how much it will cost. tell me in detail plz
Your disease, Lichen Planus, is discussed at eMedicine.
You will see that this is an autoimmune disease and not an easy one to treat. This is best handled by a dermatologist, not by a hair transplant surgeon, as hair transplants will fail if you have them done.
This is my story. I went to Dr. [name removed] because my front was thinning more than the rest of my hair. The doctor recommended 2489 grafts in the frontal 1 inch. He lowered my hairline because he said it was the sexy look and at 26 years old, that was a good look. After 9 months, the hair in the front was still very thin so the doctor told me to have another transplant. I purchased another 1804 grafts which did not appear to have grown out after another 10 months. I went back to the doctor and he told me that I needed more grafts. The area that he took the grafts from was very, very thin after the second transplant. I did not feel comfortable with this recommendation, so I went to another doctor to get a second opinion. He told me that I have DUPA and that the entire hair on my scalp was thin and see through. My scar is very visible. This second doctor told me that I should not have had the surgery and that I was in a bad place to do anything but wear a wig. So I went to a wig place and the wig was totally unnatural. The hair on the top was thick, the side hair was not covered by the wig and looked transparent. What do I do? Is there a place to complain about my surgical care? Do I go to a lawyer and if so, how do I find a good lawyer?
It sounds pretty clear that by having Diffuse Unpatterned Alopecia (DUPA), you were never a candidate for surgery. Hair transplant surgery in men such as yourself is a disaster and no you will probably always show this deformity. It seemed that the doctor must have needed your money and did not care about your welfare. First of all, I would like to see you, possibly get pictures from you so that I could ascertain for myself if you had DUPA. I would try the use of dutasteride (only if you really have DUPA), which would be an off-label use of this drug. I have seen some men with DUPA get a response from finasteride, but high doses of dutasteride may have value. The problem with this drug is the issue of sexual drive and low sperm counts from its use. These would be things we would have to talk about and you certainly should not consider having children anytime soon if you try this route.
Your recourse includes:
The courts are generally not victim-friendly when dealing with hair transplants, because they do not see significant damages so the monies collected in the few cases that went to court have been pretty low. For the readers out there, please keep in mind that the doctor you choose should be ethical, honest, and competent. Try to identify the larceny in the doctors before you bet your appearance on someone you don’t know and can’t research.
I would be happy to help you, but we must first somehow meet.
Hi I was diagnosed with alopecia two years ago and was receiving treatment and had hair regrowth then stopped treatment and got pregnant I am now 7 months and I’m having rapid hair loss. My question is about the baby, does my problem have any effect on the baby and will I pass it on to him in any way. I also want to know if i will loss all my hair or what should I expect to see after the baby is born and what kind of treatment is best after pregnancy.
I could have answered your questions much better if I knew the type of your alopecia. “Alopecia” just means hair loss. For example, is it female pattern alopecia, alopecia areata, or another type? You need to see a hair specialist to diagnose your hair loss. Most types of alopecia disorders have genetic influences. Genetics go from father and mother to children.
I recommend you to see a good dermatologist for treatment of your own condition and speak with your obstetrician about your concerns for your baby.
can you tell me where to find a Telogen Effluvium specialist in my area that wont charge an arm and a leg? i live in Torrance, CA
also, how long does it take for follicle that pushes out a telogen hair to start growing that anagen hair?
Unfortunately, I don’t have a local referral. Dr. Richard Strick, based in Los Angeles, specializes in alopecia, so it is a possibility that he would be a good source for a second opinion.
The telogen phase usually lasts 3-6 months and it varies person to person. TE can be chronic or acute and it may have causes such as trauma, systemic diseases, chemotherapy, drugs, hair transplants, any surgery, etc.
Hi, i am almost 20 years old and have seen a few derms regarding my hair loss, it looks like a have DPA, strong hair on frontal tuft, sides and back, my thinning hair is blonde and on the remaining areas of my scalp. i am on propecia, but would like to know your opinion on what surgical advice you could give me. I know its best to wait as long as possible but when would be the appropiate time to schedule a surgery? also, do you recommend FUE for patients with DPA?
thanks so much
I would need to examine you myself and perform a miniaturization study to determine what you actual diagnosis is. I can not offer you surgical advice without understanding the diagnosis, where your hair loss is at the moment, and more about your overall history (including family history). In other words, each patient is different, so I really can’t give you a clear cut time without an exam.
As you indicated that you’re in Southern California, I invite you to call 800-NEW-HAIR to setup a free consultation in my Los Angeles office.
For those curious about DPA, I’ve written about it before:
Diffuse Patterned Alopecia (DPA) is an androgenetic alopecia characterized by diffuse thinning in the front, top, and vertex of the scalp in conjunction with a stable permanent zone. Diffuse Patterned Alopecia is usually associated with the persistence of the frontal hairline represented by the hairline position of the Norwood Class II or Class III patient.
