Do I have DUPA and what options do I have?

[Thinner]

Hey all, new to the forum 

I am a 37 year old male with thinning hair, I have had thinning hair for maybe over 15 years at a slow pace but I feel like my hair has been miniaturizing more over the last few years due to stressful life events. My hairline is ok for the most part. I have a bald spot on the left area of the crown. My hair is all around thin including the sides and back (donor area)

I am not sure if I have (dupa) diffuse unpatterned alopecia as I have never been medically told that I do or not. 

I’m healthy for the most part aside from stresses of life. I don’t have any medical conditions or diseases that I know of. I don’t take any medications for any health issues or any medications for my hair, I have never had a hair transplant 

I have a full beard for the most part, my chest hair is curly and a little sparse but it’s there

I would like to know if I am a HT candidate and if so by looking at pictures if you think my donor area is ok or not and possibly my beard to head? Or body to head? 

What options do I have if any? Or am I pretty much screwed?

I want to get a transplant done if possible. I’m in the states, thinking about going to turkey if anything can be done. I understand I have to speak to a specialist but any thoughts? I have reached out to a few through email but haven’t received a response yet. I have contacted Dr. Ozlem Bicer 

[AB2000]

If you had said you've had a HT in the past then I'd hazard a guess your scalp donor is overharvested.  Since you haven't had anything done, there might be something else going on, other than male pattern baldness.  Find a dematologist who can do skin biopies to rule out other skin disease.  If it's LPP then start treatment.

[Thinner]

10 minutes ago, AB2000 said:

If you had said you've had a HT in the past then I'd hazard a guess your scalp donor is overharvested.  Since you haven't had anything done, there might be something else going on, other than male pattern baldness.  Find a dematologist who can do skin biopies to rule out other skin disease.  If it's LPP then start treatment.

Interesting as I do suffer with lichen planus and oral lichen planus which is also an autoimmune disorder that has no know cause, thanks for the suggestion, I’ll be seeing a dermatologist soon

[Zoomster]

Unfortunately if this isn’t DUPA i don’t know what is ..you’ll need an in person evaluation to confirm it though .

The juice won’t be worth the squeeze pursuing a HT would be my opinion.

[Thinner]

4 minutes ago, Zoomster said:

Unfortunately if this isn’t DUPA i don’t know what is ..you’ll need an in person evaluation to confirm it though .

The juice won’t be worth the squeeze pursuing a HT would be my opinion.

Ahh, I know. It seems to me it’s a very rare form of hair loss or thinning as I haven’t really seen many peoples hair like this. When I wake up in the morning it is very patchy looking just from laying on a pillow. 

[Gramatik]

It looks like DUPA. You need to start finasteride 1mg per day and see after 6 months how your donor will react to the treatment. Then reassess after 12 months.

[Thinner]

4 minutes ago, Gramatik said:

It looks like DUPA. You need to start finasteride 1mg per day and see after 6 months how your donor will react to the treatment. Then reassess after 12 months.

I understand that not everyone gets the side effects but I must say am I scared to start fin due to fears of Erectile Dysfunction. I feel like this hair loss has a tight grip on my life. 

[Gatsby]

@Thinner I would highly recommend that you see a good dermatologist. Commencing finasteride and oral minoxidil would really be your best options at this stage. All the best!

[Gramatik]

9 hours ago, Thinner said:

I understand that not everyone gets the side effects but I must say am I scared to start fin due to fears of Erectile Dysfunction. I feel like this hair loss has a tight grip on my life. 

Side effects are only a small percentage.Finasteride is your only hope if you have DUPA, because if you have DUPA then there's no safe zone in the donor and you need to keep taking finasteride to stop the miniaturization of your donor.

[Zoomster]

11 hours ago, Thinner said:

Ahh, I know. It seems to me it’s a very rare form of hair loss or thinning as I haven’t really seen many peoples hair like this. When I wake up in the morning it is very patchy looking just from laying on a pillow. 

I think Dr lorenzo carved out of bit of reputation for putting DUPA patients on finasteride and minoxidil for 1 year then proceeding to surgery ..the advice given here already to commence meds for 1 year is sound ..if you’re a good responder it might change the outlook for you ..Give it a try 

Edited December 30, 2022 by Zoomster

[AB2000]

On 12/29/2022 at 6:27 PM, Zoomster said:

Unfortunately if this isn’t DUPA i don’t know what is ..you’ll need an in person evaluation to confirm it though .

The juice won’t be worth the squeeze pursuing a HT would be my opinion.

Zoomster, you are not following the information here.  The OP actually answered his own question.  He asks if it looks like he has DUPA (diffused alopecia) but then states in a followup response that he has an autoimmune disease affecting the hair:

Quote

Interesting as I do suffer with lichen planus and oral lichen planus which is also an autoimmune disorder that has no know cause

The distinction needs to be understood for correct treatment.  DUPA is an aggressive form of hair loss, extending into the traditional safe zone, making hair transplantation not viable.  Any hair used is going to experience the same problem in the recipient area.  This is a disease of the hair.

Lichen planopilaris (LPP) is a disease of the skin, not the hair.  Scarring forms underneath the skin as the body's white blood cells start attacking this area in an autoimmune response.  This kills off the root of hair.  LPP is not male pattern baldness, it's skin inflammation that attacks where the hair grows from.

@Thinner, you need to see a dermatologist who specializes in Trichology ASAP.  They can confirm the LPP with skin biopsies.  Don't spend tens of thousands of dollars on a hair transplant that will fail because the underlying cause of the hair loss - the skin disease - is thus far untreated.  Getting on antibiotics, scalp ointments and using natural botanicals will instead cost hundreds of dollars and will stop the hair loss.  Then think about hair transplantation.  If you let this LPP go untreated you are throwing your hairline away.