Do I have DUPA and am I a good candidate for a HT?

[Hwar8657]

Hello everyone, I appreciate all of the knowledge on this forum, and I decided to make an account to ask if I would be a good candidate for a hair transplant. I’ve been losing hair since I was around 20 years old and I’m now 28 and it seems to have leveled off somewhat in the past year or so but it’s hard to tell. I use minoxidil daily and dermaroll but that’s it, unfortunately had to stop finasteride due to side effects. I read that hair transplants shouldn’t be an option for those with DUPA but I don’t know if I have it, was concerned with how my hair loss looks towards the bottom of my crown and the back but not sure if that’s normal for advanced hair loss. My other main concern is the density of my donor area, but that’s also hard to judge because I always keep my hair cut short anyway. I also don’t know what stage of Norwood I would be classified as, if I had to guess I would say 6 but not really sure. If HT isn’t an option what medications are recommended other than Min/Fin and Keto? Any advice would be appreciated, thanks! 

[mister_25]

I don't think you have DUPA judging from these photos. 

I would say you are a Norwood 6, maybe your crown is dipping a little bit into Norwood 7 territory. Your sides go up quite high compared to normal norwood 6/7s so you got that in your favor.

A good alternate to Finasteride is Dutasteride, but it has its own side effects. You can also try topical finasteride. You have a bit of hair at the bottom of your crown that you might be able to stabilize/recover which would go a long way if you decide on a hair transplant.

If you were to get a hair transplant, you would be a difficult case and you would need to go to a doctor that is skilled in your Norwood class. Dr Sethi (Eugenix), Dr Pitella are the two doctors that I would reccomend. Dr Zarev has impressed me as well but he doesnt have as strong as a portfolio as the other two.

[Delta Bravo]

I agree 99% with @mister_25. 
One more input could be try contacting Eugenix and Pitella, personally I've been to Eugenix and saw many tremendous results of higher NW. I can vouch for them. 

You can also try to get the front and mid restored only for now, continue with medications for the crown. 

[Al - Moderator]

It doesn't look like you have DUPA. I'd classify you as a NW 6. If you are looking into a hair transplant, you have hair that goes high up on the sides which is good, but FUE scars tend to show up more on darker skin and you will need a lot of grafts.

 

 

[Hwar8657]

11 hours ago, mister_25 said:

I don't think you have DUPA judging from these photos. 

I would say you are a Norwood 6, maybe your crown is dipping a little bit into Norwood 7 territory. Your sides go up quite high compared to normal norwood 6/7s so you got that in your favor.

A good alternate to Finasteride is Dutasteride, but it has its own side effects. You can also try topical finasteride. You have a bit of hair at the bottom of your crown that you might be able to stabilize/recover which would go a long way if you decide on a hair transplant.

If you were to get a hair transplant, you would be a difficult case and you would need to go to a doctor that is skilled in your Norwood class. Dr Sethi (Eugenix), Dr Pitella are the two doctors that I would reccomend. Dr Zarev has impressed me as well but he doesnt have as strong as a portfolio as the other two.

Thank you so much! Yes I plan on starting 0.02% topical finasteride. I’ve heard of those doctors but apparently they’re on the more expensive side, also are they experienced with black hair? My hair is pretty straight when it’s low but curls as it grows longer, I used to have an afro, so don’t know if I would be as difficult as other people with afro hair that’s more curly at the base. 

[Hwar8657]

8 hours ago, BeHappy said:

It doesn't look like you have DUPA. I'd classify you as a NW 6. If you are looking into a hair transplant, you have hair that goes high up on the sides which is good, but FUE scars tend to show up more on darker skin and you will need a lot of grafts.

 

 

What is the best method of FUE to minimize scarring? I’ve heard of Sapphire and the DHI technique. 

[Hwar8657]

10 hours ago, Delta Bravo said:

I agree 99% with @mister_25. 
One more input could be try contacting Eugenix and Pitella, personally I've been to Eugenix and saw many tremendous results of higher NW. I can vouch for them. 

You can also try to get the front and mid restored only for now, continue with medications for the crown. 

I’ll consider this, unfortunately because my crown is balding low towards the back it’s still noticeable from behind so I was hoping a HT would be able to address everything, although I know it wouldn’t be easy due to my advanced stage. 

[Melvin- Admin]

It’s difficult to assess whether or not you have DUPA based on photos alone. Your candidacy depends on your expectations and goals. You have to understand that your hair will require multiple procedures to get optimal density and coverage. It will cost a lot of time and money. Make sure you’re fully invested and not looking for a quick fix. Hair transplants are not a quick fix.

[Dillpickle123]

If your willing to use beard grafts you can get a decent result 

[BaldReaper]

just shave it,you are not a good candidate

[Pbaird98]

I do agree that you should at least try the shaved head, fierce beard combo, always worth a go!  Rather than a long ass journey and lots of dollars spent on hts/smp/meds etc. yeh it’s possible to get a ht, but try the free option 🤜🏿

Edited October 22, 2022 by Pbaird98

[gillenator]

You are still quite young and so I recommend that you wait on any surgery and get a full microscopic exam for now…you need to know the viability of your donor and the extent of future recessionary loss in the crown and on your sides (lateral humps).

[Hwar8657]

16 hours ago, Pbaird98 said:

I do agree that you should at least try the shaved head, fierce beard combo, always worth a go!  Rather than a long ass journey and lots of dollars spent on hts/smp/meds etc. yeh it’s possible to get a ht, but try the free option 🤜🏿

I haven’t ruled this out either, I think for now I’ll try other solutions and maybe hope for another cure (pyrilutamide perhaps?) 

[Hwar8657]

10 hours ago, gillenator said:

You are still quite young and so I recommend that you wait on any surgery and get a full microscopic exam for now…you need to know the viability of your donor and the extent of future recessionary loss in the crown and on your sides (lateral humps).

Yes I think I’ll hold off for now and try other treatments, thank you for the advice! Also thanks to everyone else! I really appreciate it. 

[gillenator]

You definitely want to know if there is significant miniaturization in your lateral humps.