strange thinning on the side of my head

[samsunggalaxy]

Hello everyone

I am around 25 and have hereditary hairloss. The top of my head is diffuse thinning and I am not surprised by that. I was also not too worried about it because I was planning to get a hair transplant. What shocks me however is how strangely thin the side of the head looks.

It's very prominently thin unless I comb all the hair down properly. When I wake up from bed, it looks like a mess. Ironically despite the top of my head being most miniaturised, people have spotted my thinning side of the head more.

Here are some pics with and without flash

Edited February 15, 2021 by samsunggalaxy

[Curious25]

Could be DUPA or a slightly early onset of retrograde alopecia. 
 

You’re best off having an in person consultation with a reputable hair surgeon to see what’s going on, I’d be tempted to suggest avoid wasting your time consulting with a GP or dermatologist, as they have a more general understanding of hair loss issues, as opposed to the specialists in the field of hair restoration, who dedicate their whole craft to dealing with hair loss day in day out. 
 

Some of the active doctors on the boards may also be able to chime in and give their opinion going off the pics you have kindly provided. 

[samsunggalaxy]

Thank you @Curious25

I'm terrified of DUPA as it is pretty the only class of patients who may not get hair transplants. The top of my head is pretty diffuse bald already (like 60% gone) so I was planning on a hair transplant soon.

I would appreciate it if I can get an opinion of doctors or experts here.

Are there good surgeons out there who do video consultations? I want to consult with really good doctors. I've met doctors in person, one who said it's just normal MPB, one who said it's from a vitamin deficiency, one who said it's due to stress. Like you say, it seems like there is need of very specific knowledge here.

[Britanium]

Paging @DrTBarghouthi 🙏

[Curious25]

23 minutes ago, samsunggalaxy said:

Thank you @Curious25

I'm terrified of DUPA as it is pretty the only class of patients who may not get hair transplants. The top of my head is pretty diffuse bald already (like 60% gone) so I was planning on a hair transplant soon.

I would appreciate it if I can get an opinion of doctors or experts here.

Are there good surgeons out there who do video consultations? I want to consult with really good doctors. I've met doctors in person, one who said it's just normal MPB, one who said it's from a vitamin deficiency, one who said it's due to stress. Like you say, it seems like there is need of very specific knowledge here.

Hopefully it’s not DUPA 🤞🏻

[DrTBarghouthi]

Thanks for the mention guys. I feel for you my friend. It is hard to assess properly by photos and even by online consultation. I would really need dermoscopy to assess miniaturization properly. However, on on of your photos I do see a variation of thickness between hairs in that area which can be suggestive of DUPA if this thinning extends to beyond 20 % of your hairs in the donor. I suggest to see a hair doctor locally at least. If DUPA then I wouldn't worry as it doesn't mean it is the end of the world. You just need a strict maintenance on finasteride to start with.

[Britanium]

Thanks @DrTBarghouthiappreciate your prompt response ! Always on hand for good advice 🙏

[Melvin- Admin]

That absolutely appears to be DUPA. I’d strongly suggest contacting a dermatologist and getting a physical exam. 

[samsunggalaxy]

Thanks for the replies everyone.

@DrTBarghouthi thank you! My back donor area is quite solid but even nape hair are thinning out. Basically all my hair except that narrow patch of donor area hair is thinning out. Isn't this more indicative of retrograde alopecia than DUPA?

 

[samsunggalaxy]

2 hours ago, Melvin-Moderator said:

That absolutely appears to be DUPA. I’d strongly suggest contacting a dermatologist and getting a physical exam. 

Hey, this is you right? 

 

I was searching for retrograde alopecia and found that. Isn't mine more like retrograde alopecia? The hallmark characteristics are thinning above the ears and thinning of nape hair. I have both these. However my "core" donor strip area looks strong so far.

[Melvin- Admin]

2 minutes ago, samsunggalaxy said:

Thanks for the replies everyone.

@DrTBarghouthi thank you! My back donor area is quite solid but even nape hair are thinning out. Basically all my hair except that narrow patch of donor area hair is thinning out. Isn't this more indicative of retrograde alopecia than DUPA?

 

If that spot were above your ears, yes, but it’s not. The hate to say it, but it looks indicative of DUPA.

 

 

[giegnosiganoe]

Are you taking any medication for hair loss? Finasteride or minoxidil?

[Melvin- Admin]

27 minutes ago, samsunggalaxy said:

Hey, this is you right? 

 

I was searching for retrograde alopecia and found that. Isn't mine more like retrograde alopecia? The hallmark characteristics are thinning above the ears and thinning of nape hair. I have both these. However my "core" donor strip area looks strong so far.

Your thinning is 

 

retrograde alopecia is usually here

[samsunggalaxy]

20 hours ago, giegnosiganoe said:

Are you taking any medication for hair loss? Finasteride or minoxidil?

I apply Minoxidil but doubt it's doing anything. I don't take Finasteride.

[samsunggalaxy]

Thanks for pointing it out @Melvin-Moderator It's quite disheartening. My only ray of hope is that my core donor area is intact so far and in DUPA cases I see that there are patches there as well.

Are DUPA / retrograde alopecia really separate things with some chemical demarcation between them? Or is it just a surgeon's opinion based on how they see the miniaturisation? I am quite frustrated with visiting GPs and dermatologists about this because nothing constructive comes out and I have received contradicting opinions. Everyone suggests Finasteride of course but I don't want to be on it. Some suggest saw palmetto and vitamins. I get a feeling that it's all guesswork because nobody has found anything wrong in my blood work.

[Melvin- Admin]

1 hour ago, samsunggalaxy said:

Thanks for pointing it out @Melvin-Moderator It's quite disheartening. My only ray of hope is that my core donor area is intact so far and in DUPA cases I see that there are patches there as well.

Are DUPA / retrograde alopecia really separate things with some chemical demarcation between them? Or is it just a surgeon's opinion based on how they see the miniaturisation? I am quite frustrated with visiting GPs and dermatologists about this because nothing constructive comes out and I have received contradicting opinions. Everyone suggests Finasteride of course but I don't want to be on it. Some suggest saw palmetto and vitamins. I get a feeling that it's all guesswork because nobody has found anything wrong in my blood work.

They’re both forms of genetic hair loss, except retrograde alopecia is concentrated at the nape and above the ears. DUPA can occur anywhere at anytime on the donor. It’s a lot less predictable. Both can be treated with anti-androgens like finasteride and dutasteride. Have you tried fin?

[samsunggalaxy]

1 hour ago, Melvin-Moderator said:

Have you tried fin?

Yes I was on it for some time and it seemed to work. But I had side effects while I was on it.