Is this possibly DUPA?

[mahhong]

Firstly, I know no definitive diagnosis can be made here and I will be visiting my GP and a hairloss expert when time and money allow - I'm just canvassing some general opinion in the meantime.

 

To try and keep it to a minimum; I'm 33, currently not on any medication. I'm balding in a NW5 pattern and have been since about 2008; pretty extensive loss throughout the top of my head but crown isn't huge and sides fairly high, and they don't seem to have dropped much or opened out in the last 8 years. Still have some diffuse hair in the mid-scalp and just enough in the hairline/crown to get away with concealer, but it's becoming increasingly difficult! No doubt the hair up there is on its way out over time - hard to tell if the exact pattern is established but no obvious signs I'm rushing towards a NW6/7 after nearly a decade of loss.

 

Anyway, I'm going to have to start thinking seriously about restoring my hair now. I should have done it a few years ago but, alas, we live and learn. I did try finasteride a few years ago but long story short, I seemed to get sides. However I'm thinking of starting Min/Lipogaine and have recently been using Nizoral, and of course hoping eventually for surgical restoration. Family hairloss that I know of; my father is probably a "NW5.5" (fairly high sides and diffuse hair on top, but pretty big crown loss) and he also appears to have some retrograde alopecia in the back/sides (hard to say as he buzzes but seems that way). Maternal grandfather was a full blown NW6/7 and in his old age had a very thin donor (but this was deep into his 70s/80s, it was possibly just that he had white hair and it was quite wispy at that point). Paternal grandfather is sort of a NW3V - has generally thinned a little on top and some mild crown/temple loss but still has a relatively full head of hair in the midscalp and hairline (apart from the recession). My hairloss pattern SEEMS to be following more my father/his father than my maternal grandfather, as he had fairly extensive, deep temple loss by 26/27 (I had barely started thinning then) and to my knowledge it went pretty quickly from there, but of course this doesn't guarantee anything for definite.

 

That's my background! My question, though, is actually about DUPA. I've noticed on some incidental photos of me recently that my sides looked a little thin and I was pretty shocked when I took my own photos recently. There does appear to be a general thinning across the sides of my hair (not just retrograde either). The back of my head looks stronger to my eyes. I've posted photos to get your opinions and thoughts (these photos were taken in a fairly bright room with a window for lighting, but there is no strong sunlight or other powerful direct light source):

 

Side (both sides are similar):

 

Hair Restoration Social Network ? Community for and by Hair Loss Patients

 

 

Back (note general crown loss - I also have a thin patch beneath the crown but to my knowledge my hair has always been this way, as I remember thinking it in my teens, and is partially due to combing - or lack of!):

 

Hair Restoration Social Network ? Community for and by Hair Loss Patients

 

 

Anyway to my eyes there would appear to be definite, non MPB thinning across the sides. I've become worried I'm a victim of DUPA but the back seems fairly strong, to my knowledge there isn't any history of it in my family (paternal grandfather possibly, but I think his donor region hair just went white and thinned with old age and therefore looked thin and wispy). Also, and I'm not sure how true this is, but I'm led to believe somewhat that DUPA is usually aggressive and shows fairly young? I can't recall noticing this problem except perhaps within the last year or two.

 

I wonder if this is perhaps a problem other than DUPA, possibly thyroid or autoimmune? Again, I know I'll have to get that diagnosed properly (and will do so when I can and keep you updated), but just interested in hearing thoughts or other experiences. I notice my scalp has been feeling a bit itchy all over the last few weeks, possibly months, but hard to tell whether this is not just because I'm more aware of my hair and more sensitive to it? It's also been a bit inflamed recently but that might just be sunburn (I don't have the coverage I used to!). I would also say the last couple of years my eyebrows seem a bit paler and wispier - I still have them but I'm sure they were darker and fuller at one point.

 

I don't take any long term medication or have any known medical issues and to my knowledge am fairly fit and healthy (diet and exercise not the best, but not overweight, in fact have deliberately lost 4 stone over the last 14 months). I would say I have mild to moderate stress with a combination of things, but nothing major - probably what most people experience between jobs and personal life (and hair loss!). I had blood work done about a year ago and it was fine - but I didn't have my thyroid checked, it was just a full blood count plus testosterone (which was low-normal).

 

Anyway, just documenting my journey starting with this first road bump! I will get a proper diagnosis and see a hair specialist soon, just to rule other stuff out, but in the meantime I wanted to get some thoughts. DUPA is quite rare and I don't know of any obvious cases in our family, so a part of me wonders if other diseases or problems would be more likely. I obviously hope so, as if it is DUPA that doesn't really bode well!

[Melvin- Admin]

It looks more like retro alopecia to me, because the sides above the ear are thin and the nape is a bit thin too, however i agree the back does seem strong. DUPA generally has thinning throughout the entire scalp. Only way to know for sure is to get the donor checked for miniaturization, if you have more than 20% miniaturization then u may have DUPA.

[n00b]

HTsoon,

 

Do you know where one can get his scalp checked for miniaturization scientifically?

[Melvin- Admin]

HTsoon,

 

Do you know where one can get his scalp checked for miniaturization scientifically?

 

Dr. Mohebi here in LA, if you follow him on snap chat he always displays the percentage of miniaturization in the entire scalp, he does charge $150 for the consult though, but there have been cases where he'll take a biopsy to check for alopecia areata. So in my opinion $150 isnt bad especially if you have doubts about possibly having DUPA or other forms of alopecia.

[mahhong]

Thanks for your input HTsoon (and congrats on a great procedure, by the way!).

 

I agree that retrograde alopecia is fairly likely, however I'm also a bit concerned that the hair looks pretty thin further up too. However I know this could also be a combination of the hair angle, combing, lighting etc. in addition, I know the density here is often not quite as high as the back. I also suspect my hair is angled rather oddly in this area. All my life I've suffered terribly with hair that just won't "lie down" properly around the upper fringes of the back and sides - it's always sticking up and moving in weird directions! I do think this contributes a little.

 

Anyway a little retrograde alopecia is in my family, so I have to accept there's a fair likelihood it could happen to me. I'm worried about DUPA, but to my knowledge that is not in my family history and is less likely (nothing is impossible though!).

 

I'll hopefully be seeing an expert in 4-6 weeks. I'm also going to be seeing my GP to try and rule out any thyroid/vitamin/hormone issues. I do have some other symptoms that could be attributable to conditions that cause hairloss like hypothyroidism, iron deficiency etc, but often these symptoms are so vague and numerous almost anybody can find a reason to believe they might have them! A proper workup will hopefully help, followed by a good analysis by an expert.

 

Thanks again for your reply!

[n00b]

Dr. Mohebi here in LA, if you follow him on snap chat he always displays the percentage of miniaturization in the entire scalp, he does charge $150 for the consult though, but there have been cases where he'll take a biopsy to check for alopecia areata. So in my opinion $150 isnt bad especially if you have doubts about possibly having DUPA or other forms of alopecia.

 

Thanks for the info HTsoon.

Do you happen to know any doctors in the greater Seattle area doing a similar analysis?

[ontop]

It looks to me that its A.A with a tight scalp.

 

Look up the HT surgeons on this website, who is close to your neck of the woods.

let us know what the verdict is will you, be interresting for me & others.