What is Diffuse Unpatterned Alopecia (DUPA)?

This question comes from a member of our hair loss social community and discussion forums: 

I’ve been losing my hair for several years. I initially thought I suffered from androgenic alopecia or male pattern hair loss; however, members of online forums now say it may be diffuse unpatterned alopecia or DUPA. What is DUPA? Can it be fixed with hair transplant surgery?

I’m not 100% sold on the idea of “DUPA” or it’s cousin “diffuse patterned alopecia” (“DPA”).

Traditionally, non-scarring alopecia is broken down into several categories: focal, patterned, and diffuse. Focal alopecia includes conditions like alopecia areata; patterned includes androgenic alopecia and female pattern hair loss; and diffuse covers conditions like telogen effluvium, anagen effluvium, loose anagen syndrome, atrichosis, and hyoptrichosis. However, it does not – traditionally – include “DUPA” or “DPA.” Maybe the categorization is out of date, but I generally try to stay away from these terms – or at least from DPA. I do understand that “DUPA” is a good description for one clinical picture – which I will explain below.

I would classify hair loss fitting this diffuse pattern as follows:

Either: diffuse androgenic alopecia that is best described by the Ludwig and not the traditional Hamiltion-Norwood hair loss scale; OR you could call it diffuse unpatterned alopecia if you are experiencing thinning in the donor region (which is the only time I really think this term is appropriate).

Generally, DUPA patients aren’t the best surgical candidates. The only caveat to this is when preventive medications like minoxidil (Rogaine) and finasteride (Propecia) are used to stabilize the donor and allow for transplantation. Remember, it is important to undergo a thorough scalp examination with a trusted hair restoration physician to fully understand your type of alopecia and treatment options.
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Blake Bloxham – formerly “Future_HT_Doc”

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