DUPA, Retrograde Alopecia or?

[KLHT]

Hey everyone,

 

23 years old turning 24, very advanced hair loss. I know that I will need to be examined by a doctor to know for sure, but based on visual inspection, do you think this is DUPA? I'm very concerned that it might be. Do you think it's just retrograde alopecia? Or a crappy hair cut with the scissors that reduce the volume (I had one for the sides and back last week)

 

I took these pictures in harsh lighting without trying to cover the thin spots to give you an idea of what I'm talking about. The sides are what concern me. The back is still strong though with no thinning except for the nape maybe. (I do shave my neck btw)

 

Family history shows MPB; my father is a NW6 but his donor is still pretty good. I feel his sides are similar to mine as well, but his donor in the back is still strong. ( there are pictures of my father's hair in another thread of mine). Other than that, none of my family members have DUPA.

 

Important point to note is that I have sent images to several recommended and coalition doctors on here. Some have accepted to operate on me while others said it is better to wait due to my young age. None specified that I might have DUPA except for one who said that I might have donor thinning and should start Finasteride. He didn't mention DUPA though. (I've been on Minox for 4+ years) This is not the point here but I felt such information would be relevant to include in this thread

 

Opinions?

[DavidAnderson]

Tough to say for certain from photos alone but it is common to see patients with a noticeable imbalance of density from the back to the sides you could just have low density at the sides which judging from the photos imo would be risky to take hair from these areas by either FUE or FUT. It could be retrograde but it could also point to a very aggressive pattern of loss in the future.

 

If you are 23 advanced hair loss and not stable on meds I don't think you should be considering a transplant until you have been on meds for at least 6 ideally 12 months.

[KLHT]

Tough to say for certain from photos alone but it is common to see patients with a noticeable imbalance of density from the back to the sides you could just have low density at the sides which judging from the photos imo would be risky to take hair from these areas by either FUE or FUT. It could be retrograde but it could also point to a very aggressive pattern of loss in the future.

 

If you are 23 advanced hair loss and not stable on meds I don't think you should be considering a transplant until you have been on meds for at least 6 ideally 12 months.

 

Thanks for the reply David! By meds you mean Finasteride? As specified I've been on meds and vitamins: Minoxidil for 4+ years, started Biotin, and will be adding other vitamins and Lipogaine shampoo to my regimen.

 

I'm hesitant about Fin due to the issue of permanent side effects, especially that I'm at such a young age.

[mikeyhwk]

have you actually had sides, or is the worry about sides stopping from even trying it. I never get the guys who say I worry about the sides, they hit a small percentage, even if it is higher than the studies indicate, you're still looking at, at least 90%+ odds that you won't have sides. There are also methods to take it where you don't have to take a full dose to get benefit so you can reduce potential sides. I'd at least try it before writing it off.

[Spanker]

I would only recommend fin at this point as well. I dont know if I would classify it as true DUPA because you are a patterned norwood 5. As far as retrograde alopecia, my understanding is that it travels up and the fringe of your sides and back do not look they are thinning upwards like that. I would just say you have donor thinning.

[JON86]

Only way to know for sure is get it checked out in person. Pictures are not reliable when trying to diagnose a loss pattern like this. I understand why you are concerned about the sides as they do appear to be quite thin. As far as DUPA goes there just isn't a lot of information out there. I have read articles from both DR Rassman and DR Bernstein on the subject but there is little else. As they suggest you would need to have your donor on the sides checked for miniaturization. According to what Dr Rassman wrote if you have more than 20% you probably can be classified as having DUPA. Worst thing you can do is self diagnose yourself. I did that drove myself crazy and later was relieved to find out I was completely wrong. You could be the victim of a bad haircut for all we know. I agree with what others have said propecia seems like the only thing you should consider at this point.

[KLHT]

Thanks for the replies mikeyhwk, Spanker and Jon. What is driving me away from Finasteride are not the side effects, but the reported permanent side effects that some people have reported. Other than that, I would have no problem trying the medication then stopping it if I get the sides.