Do fin or min+fin work well for diffused thinners? Also please give advice on regimens that have worked for you if you’re a diffused thinner. I am 18 years old.
Diffuse thinning has many causes. You need a good examination by a hair doctor that understands hair loss and hair thinning. If it is part of the genetic hair loss that you inherited, then finasteride and minoxidil are the staples of treatment.
Is it the occurrence of shedding all over the top of the scalp? From what I understand there are two major camps of hair loss suffers, the diffusers and the miniaturizers… and sometimes both. But anyways what exactly is diffuse thinning? I get mixed answers all over the place
Hi Dr Rassman!
I’ve been said I have male pattern baldness by a doctor. I’m currently 21 years old I lose my hair since I was 14. From reading articles over the internet, I think I have DPA (Diffuse Patterned Alopecia). My hair is thinning on the top, but remains thick on the sides. I have loss at the temples and crown in a diffuse way, but not restricted to these places (also thinning all the top). I currently take Propecia since I was 18. I don’t know if it’s helping, but I take in case it would be worse without it.
I’d like to know what causes DPA. Is it really androgenetic? Can it be from poor diet and life style? Is it reversible? What are the best options for treatments? Thank you for your attention and this excellent website!
Diffuse patterned alopecia (DPA) in men is mostly genetic in origin and Propecia (finasteride 1mg) is a good way to treat it. Have you had your hair mapped out for miniaturization to be sure? What is the result of your hair pull test? This test may point to a diffuse telogen effluvium. I can not really diagnose you via this site without examining you first.
Dear Dr,
I was wondering what the percentages are for DPA vs regular progression of male patterned baldness? I am 30 years old and have a norwood 2 or 3 pattern but most of the men in my family are bald to a large degree. Only my father has a complete head of hair.
Regards
I don’t have statistics directly comparing diffuse patterned alopecia (DPA) to male pattern baldness (MPB). We don’t get asked all that much about DPA here, so check out this link for more info.
Essentially… if you are balding from genetic causes, the hair can fall out without thinning in a specific pattern (DPA) or it can thin according to a specific pattern (MPB). In either case, the final pattern will be determined by your genes.
There is also a condition defined by us in the medical literature called diffuse unpatterned alopecia (DUPA) which reflects that the hair all over the head shows miniaturization, including the sacred donor area that is usually genetically protected in men. Most genetic female hair loss appears similar to DUPA, in that it is diffuse and over the entirety of the scalp.
I’ve have consistent diffuse hairloss universally around my head for about a year and a half, to the point where I believe I’ve lost about 60-70% of my hair. Many of the hairs that fall have large white plugs attached to them (see pictures), which I believe may be sebum.
Is this in fact sebum? Can these plugs cause diffuse hairloss? Any idea what may cause them or what might treat them? So far, I’ve tried zinc, ketoconazole, salicylic acid, coal tar, and other “sebum reducing” shampoos. I have also been on propecia for 6 months, but with no noticeable reduction in the pace of my loss.
Sebum is a waxy substance from the production of oil from your sebaceous glands. It can be seen on ends of hair follicles that fall out but this does not mean you have a hair loss condition or disease process (because of the sebum). There are products that claim better control of sebum and Internet posts that claim the sebum is the cause of hair loss. It generally makes for great marketing campaign to sell a product to those who are looking for a hair loss cure. Sebum does not cause hair loss, if it did, the many men and women on skid-row would be balding as they often do not shampoo their hair and reduce their sebum buildup. If you are experiencing diffuse hair loss, I doubt sebum is the root cause (no pun intended). You need to see a doctor for your hair loss condition to establish a good diagnosis.
(female) Dear Drs,
I was told that I most likely am suffering from Diffuse Areata, the thing that directed my doctor to this diagnosis is diffuse all over hair loss, brow and lash shed and short tapered hairs shedding out. I can find nothing on the subject, nothing on the net and my doctor admitted he did not understand the disorder.
Could you provide me with information regarding the diffuse form leaving no bald spots but diffuse loss all over the head. What is the general prognosis etc?
Thanks for your help
First, I want to tell you that clinical medical science is a descriptive science in many situation. This is important because what we see is what we are reporting when we diagnose diffuse alopecia areata. What doctors are saying is that there is a diffuse form of the disease that mimics classic alopecia areata, except that it is found all over the head. Some doctors question if this is the same disease, but because it looks like the same entity when the skin is biopsied as localized alopecia areata, the conclusion is that the diffuse variant is different in ways that are not understood. Most people believe that it is an autoimmune disease and we see evidence in what we call chronic and diffuse alopecia areata of the microscopic changes seen in autoimmune diseases.
Second, I can point you to some sites of interest so that you can learn more (but hopefully not confuse you):
2008-04-10 15:32:382008-04-04 14:25:02Diffuse Hair Loss
Hi doc,
How do you tell the difference between Telogen Effluvium and Diffuse Alopecia Areata?
Diffuse alopecia areata can look very similar to telogen effluvium. The only way to tell these two diagnosis apart is by performing a series of biopsies of the scalp. Alopecia areata can be diagnosed histologically.
2009-02-18 09:32:012009-02-12 15:13:49Diffuse Alopecia Areata vs Telogen Effluvium
I have been using Differin topical solution on my forehead every night for nearly six years. I have recently noticed that I am losing hair that was transplanted three years prior. I did some research on the web, and there is some mention that other people (although few) seem to have experienced the same. The drug company and the prescribing dermatologist made no mention of hair loss being a potential side effect. In your professional opinion, is it possible that this topical derivative of vitamin A (related to the dreaded hair loss drug accutane) could be causing my transplanted hair to fall out after six years of use? Any input would be greatly appreciated.
Differin is a topical medication used for the treatment of acne. Losing hair is not reported as a side effect of this medication, but many of the acne drugs do cause hair loss. See the doctor who prescribed the medications to evaluate your hair loss. Maybe you are losing your native hair. It would be unlikely (but possible) that a medication that you used for six years without any problem is now causing your hair loss.
2007-03-09 12:34:322007-03-09 12:34:39Differin and Hair Loss
I had my transplant at NHI 9 montys (2000 grafts to the front). My hair is growing very fast, and looks awesome, except that it is curly, and the rest of my hair is absolutely bone straight. I am growing my new “full” head of hair long and “surfery” looking, but it looks so different with a curly, puffy front, and then the rest is long, flowing and stick straight. Will the front ever be straight? What can be done? I use a hot flat iron every day to try and straighten it.. I know totally why people with curly hair hate humidity and rain…instant frizz. Help.
Hair transplants rarely radically change the character of the hair, but it can happen. In about half of the people when this change occurs, the hair will straighten a bit after going through a hair cycle. I remember one person who had a very radical curly change to his hair after the first surgery. I personally did not like it at all, but he loved it. When he came in for his second transplant, the same thing happened again. It remained very curly and he could not have been happier. Much to my surprise, it lasted through a hair cycle, possibly a bit less curly.
Some people who get changes in hair characteristics, go to a slightly more wavy hair and this change is appreciated in almost every person because it produces ‘body’ for styling that they never had when their hair was very straight. This often reverses in a hair cycle (about 2-6 years), so these benefits may not last.
With regard to your situation, you need to see me personally so that I can review your change in hair character. In addition, unfortunately, you will have to learn to control the hair with relaxers that will allow you to gain better better control of styling. Blow drying and conditioners may help a great deal so that you may not have to use an iron. We should discuss this together. Call my office at 800-NEW-HAIR to schedule a visit.
I’m told that there are two different processes for this procedure, one for a client with hair and another method for clients without hair. My understanding is the client must decide before the procedure which they want because the process for buzzed/shaved hair will not look right with the method used for longer hair and vice versa.
1. Is there two different methods, one for buzzed/shaved hair and one for hair with a longer length if so why and what is the difference between the two methods?
2. You indicated in an email that the same amount of dots are used for an individual with hair as one without. Why?
3. If the method for clients who want to leave some length to their hair is different from clients who have shaved/buzzed hair and the client must decide which method they want before the procedure, because the method for buzzed/shaved hair won’t look right with clients who leave some length to their hair what happens if the clients hair thins out in the future? Will it not look right?
4. I’m told the hair must be shaved/buzzed before the procedure. If that is the case, and the method for longer hair is used which they say doesn’t look right with shaved/buzzed hair is that going to look weird until the hair grows back?
5. How deep does the needle go?
6. For my situation being that I want to keep my hair longer than a buzzed/shaved length do you use dots or more of a blanket coverage. Can you explain? If you use dots what size would the follicle dot be?
There are two ways to harvest the donor hair for transplantation:
1. Take out the hairs one-by-one using a small (1mm diameter) punch. This is called the Follicular Unit Extraction (FUE) method. To do this, you need to shave the back of your scalp so that that hairs will fit into the small punch. Without shaving the area, you can individually thread each long hair into the small 1mm diameter punch, but that would be a very, very long and inefficient process. FUE will allow you to have a buzz cut or keep your hair very short later on (when everything has healed) without seeing scarring… but if you shave your head completely, you will see thousands of white dot scars. So there will be scarring there, just not a linear scar.
The needle goes in the depth of a follicle, which is about 5mm, and the dots of the FUE scar can range from 0.8mm to 2mm in diameter. It all depends on how each person heals and the size of the instruments used by the doctor. To read more about the pros and cons for FUE, see here.
2. Another method (strip surgery) is to cut out a small section of your scalp and stitch it back together, like if you had a cut to any part of your body. This section of removed scalp is taken and dissected under a microscope into individual follicles. Your body will heal with a line scar, which won’t be visible if you keep your hair relatively long. The shortest haircut should be with maybe a #2 guard on the clippers, though a #3 guard should hide the scar without any issue. If you shave your head, you will see a linear scar. This type of procedure can be done without any hair cut or shaved in the donor area, so that when you leave the office you will not be able to see any evidence of surgery, as your hair will immediately cover the incision.
You will, however, have redness in the area where the grafts were transplanted. The severity of the redness depends on your body and where the grafts are transplanted to (if it was to a completely bald area, it will be evident — if it was to an area that had some hair, you might be able to cover it with styling).
