DUPAman

I've been to a hair transplant surgeon last year, but I do not respect his opinion because he all he did was walk in the room for about one minute and look at the streaks of missing hair and conclude "DUPA". He did not bother to use a tricoscope or any device to assess my donor. I think he was one of the guys who doesn't believe seborrheic dermatitis can cause diffuse hair loss. By the way this was the son of Dr. Bernard Nausbaum in Miami who is also a transplant surgeon. I live in Miami, so I emailed Dr. Jeffrey Epstein and from these pictures, he said my donor did look thin, but that I would have 5000 grafts. He said he doesn't perform microscopic assessment of donor but offered to use his magnifier loupes. This was this morning. I'm not sure if I should consult with him. Are magnifier loupes a good measure for donor assessment?

Oh thanks @Melvin- Admin very strange, it shows when I pasted it. Didn't realize others couldn't view it. Uploaded directly to site.

Hello, Background I am a 27 year old (28 in 2 months) white/hispanic male. There is advanced baldness (Norwood 6-7+) in distant relatives but my immediate brothers, uncles, father, and maternal grandfather had full heads of hair or did not experience baldness until old age. For almost a decade, I had severe seborrheic dermatitis, which I strongly believe resulted in the majority of the hair loss I experienced in the sides and back of head. I have succeeded in clearing up 90% of it in the back, and about 80-85% in the sides (with only minor flaking). However, the hair loss in the donor never recovered. My hair loss has been stable in the sides and back for several years now. The top of my head is slowly thinning. The crown has been stable, the midscalp is losing hair the fastest but is relatively slow, and my hairline is only very slowly receding after I initially lost my temple areas several years ago. Medications I have not taken finasteride or minoxidil. Minoxidil would worsen my seborrheic dermatitis so I cannot. I am prone to sexual side effects even without finasteride, so I have elected to not take it. Goals I would like to have an IN-PERSON consultation so my donor can be microscopically assessed and see how many healthy grafts I have available for transplantion to have a successful surgery without finasteride/minoxidil medication. I have a modest lifetime goal of 1800 grafts in a single transplant, some for my hairline and some for the temple points. I am aware that I may continue to lose the hair behind it in the coming years without medication, and that I have less donor capacity than the average person. But I am also seeking much fewer lifetime grafts to compensate. My goal is simple: restore the hairline and use a hair replacement (hairpiece/hair system) behind it when the time comes. This is because the hairline is the hardest part to get right with a hairpiece. And that is why I wanted one modest hair transplant to take care of that. My goal is different than most who seek transplants as I am only interested in restoring the hairline and temple points once and not get any further transplants later for lost hair in the midscalp or crown. I also don't mind further reduction in density in the back or sides as a result of FUE transplant Please tell me what you think of my situation. Keep in mind, my donor has looked the same for years, and my thinning in the donor began at 18 before I even started losing hair in my hairline (at the same time I developed seborrheic dermatitis). Pictures of Scalp Here are pictures in various lighting. The yellow light is a standard lamp in my room with natural light from the window as well. I cut my own hair, so the sides are cut very short with electric clippers with a 16mm guard (.62 inch). The back is cut to a 9mm guard (.35 inch). The pictures that have white light is very strong light that leaves a harsh contrast.

I'm in a similar situation with my donor and wanting a HT. The sides seem to be thinning a little more every year but the back is stable. I feel like I have somewhere between 1-2k grafts in the back to use. I looked at your previous posts and we have similar hair in the sides and back. Ultimately, I'm going to consult with a local transplant surgeon. One in the past simply looked at the back and concluded "dupa" without any microscope/ biopsy evaluation so I ignored what he said as he sounded like a fking doof just concluding that without anything to back it up. Be careful who you listen to.

Yes! Keep us updated! I've never seen a hair transplant that wasn't due to androgenetic alopecia. I'm also not going to take finasteride when I do (personal choice) because my hair loss is not related to it. My hair loss (like yours) is the response to scalp inflammation. I'm surprised that your seborrheic dermatitis went away on its own after only using ketaconozole shampoo for a couple of months. Usually it's a life-long condition. What's more surprising is that your hair transplant did not bring it back, as I've heard that (with hair transplants being trauma to the scalp), people often develop seborrheic dermatitis or it can recur in people that had it before. So this is all very interesting.

I'm excited for your journey. You remind me of my own hair loss. There is some baldness in my family (distant uncles [uncles of my mom] are all bald, but her two brothers and father had full heads of hair. My dad had a full head of hair with only slight recession until his 60's. That's why when I experienced hair loss I was confused. It turns out I had severe seborrheic dermatitis causing it. There is a ton of dandruff, scales, oily hair, hair loss in patches that I've dealt with throughout my twenties. I'm trying to get that under control now so that I can go to Eugenix in a few months like you. I'm curious did you ever have seborrheic dermatitis or any skin condition? Or do you just suspect androgenetic alopecia? Anyway, excited for your 4 and 6 month updates!

That's great. Thank you very much!! @A_4_Archan

As the title states, I am only interested in getting a temple point restoration. Here are the pictures of my donor. This image is in outdoor lighting. This is inside under normal yellow room light. This is inside under better lighting. I usually cut my own hair with the 9mm clipper guard so it's very short. I would like to do a consultation with Eugenix, but I would love to get their opinion now. I am only looking to get up to 800 grafts for a temple point restoration. I understand I that I have a below average donor, which is why I am going for this. The hair up top is satisfactory to me. I have almost full coverage, a bit receded hairline, but I am only interested in temple points. With such a low graft requirement, can this be done considering the above pictures? That is my main procedure I am looking for. However, I also want to get beard grafts from under my chin transplanted into other areas of my beard. Preferrably in the same trip! I am not sure if that can be done together, or if it can be done on separate days. Please advise! @Eugenix Hair Sciences

Really wanted to see the 1 year update...

my dermatitis is now greatly reduced as well thanks to MCT oil, which was not prescribed to me by a dermatologist but instead a solution I came across after anecdotal research. However, my hair has not grown back. It does seem like I have miniaturization in the donor, but personally from looking at the dermoscopy image I linked, I feel it isn't DUPA.

Sigh, that would be great. Sadly every dermatologist I've ever been is only a generalist when it comes to hair. "Does it look like you're thinning?" "I'll prescribe you finasteride." "You've had dermatitis?" "Here's pyrrithione zinc shampoo." That's about the best I get. Are there any hair specialists who are also knowledgeable about scalp skin conditions?

Also wanted to mention you can only see the streaks (on my donor area) from one side. Pics were taken without any hair shuffling. Just straight, unedited selfies

Yes, that was a close up of a section of my donor. I'm not on finasteride due to fear of side effects. I was advised to start finasteride, but as I've had problems with depression low libido/erection issues even without finasteride, I'd rather not risk it. I've heard the caterogization of DUPA started at >=20% miniaturization in a microscope image.

I went to a popular center for hair where transplants are performed in my city for a consultation about my hairloss. I say that knowing that I am indicating a professional doctor (hair transplant surgeon) was being unclear. However, I did not have a good experience with him because he came in, saw the picture that another doctor took and concluded DUPA and left within like 1-2 minutes of being in the room without getting the full explanation of my istuation. About me I am 26 years old, have had seborrheic dermatitis for over 7 years, and have had many nights of vigorous scratching, irritation, and possible hair damage as a result. My hair has looked the same for nearly my entire life with the exception of my hairline which has started to recede a bit. Why I am unclear about DUPA However, as I explained all of this to the previous doctor before him (who also performed my scans and also listened to the full story over the course of half an hour), he didn't necessarily feel this was DUPA and even mentioned that I might even be a candidate for a transplant, since I had asked him if that would be possible for me. I understand that I've definitely lost hair around the neck area. This happened very fast a few years ago but never progressed much since. I'm not sure if this was also due to the dermatitis. So I wonder what do you all think about my situation. I am a bit vain and ideally I did want to transplant hairs from the back of my head to the front to restore my hairline. I want to enjoy my youth with great hair, as I'm sure most of us here do. I also don't mind how thin the back might end up looking as I often buzz it. I may be working with a somewhat smaller supply of donor hair than maybe some folks. But is it right to conclude DUPA and say I'm not a candidate at all?