Got confirmed DUPA after hair transplant-consultation - Advice!

[M.G]

I've been on generic Finasteride Accord for 7 ½ months. It have so far stabilized my hairloss and I have actually gotten a little bit of regrowth at the crown.

I figured finasteride will most probably never fix my mid-scalp and hairline, so a hair transplant would be my only choice together with treatments. I went to a dr. Erdogan consultation.

Let me just start off that he and his staff are very professional and friendly.

He checked my hair with his tools and he could confirm what I had been suspecting - but was told off in this forum that it was not - DUPA. That is diffuse unpatterned alopecia. He confirmed that some of my donor is miniaturizing and that he at the moment would refuse a hair transplant surgery on me.

However, he told me that I should wait for 6 months or more and see if my donor improves and then he will reevaluate my situation again.

He was very nice and gave me a full year supply of Proscar.

He told me that I should stop the generic finasteride I use and begin using the brand name finasteride (Proscar or Propecia) since according to his experiences with his patients, brand finasteride works much better.

I was disappointed but he told me that he have had many patients like me and that it's important that I continue using finasteride to continue stabilize and hopefully improve my donor, because since I got DUPA, finasteride is a must if surgery is to be made.

He estimated me for about 5000 grafts for hairline + mid-scalp, only if he would accept me in the future.
---------------------------------------

I have never stumbled upon any DUPA-sufferers in HairLossTalk.com. But surely, there gotta be some here? Right?

I've read that DUPA-sufferers usually don't respond to treatments, but according to me, I think finasteride have worked OK for me at the moment with hopefully more regrowth to come in the upcoming months.

I'm hopeful that if I show improvements in the scalp in the upcoming months, that he'll accept me.
------

2 and 7 months on finasteride:



DUPA on back and side:

 

[cyrusthegreat@hotmail.com]

Did he give you any ideas for next steps for determining the cause(s) of your diffuse loss? How can he know by just inspection whether it's genetic, disease, or some dietary deficiency?

 

[buckthorn]

I've been on generic Finasteride Accord for 7 ½ months. It have so far stabilized my hairloss and I have actually gotten a little bit of regrowth at the crown.

I figured finasteride will most probably never fix my mid-scalp and hairline, so a hair transplant would be my only choice together with treatments. I went to a dr. Erdogan consultation.

Let me just start off that he and his staff are very professional and friendly.

He checked my hair with his tools and he could confirm what I had been suspecting - but was told off in this forum that it was not - DUPA. That is diffuse unpatterned alopecia. He confirmed that some of my donor is miniaturizing and that he at the moment would refuse a hair transplant surgery on me.

However, he told me that I should wait for 6 months or more and see if my donor improves and then he will reevaluate my situation again.

He was very nice and gave me a full year supply of Proscar.

He told me that I should stop the generic finasteride I use and begin using the brand name finasteride (Proscar or Propecia) since according to his experiences with his patients, brand finasteride works much better.

I was disappointed but he told me that he have had many patients like me and that it's important that I continue using finasteride to continue stabilize and hopefully improve my donor, because since I got DUPA, finasteride is a must if surgery is to be made.

He estimated me for about 5000 grafts for hairline + mid-scalp, only if he would accept me in the future.
---------------------------------------

I have never stumbled upon any DUPA-sufferers in HairLossTalk.com. But surely, there gotta be some here? Right?

I've read that DUPA-sufferers usually don't respond to treatments, but according to me, I think finasteride have worked OK for me at the moment with hopefully more regrowth to come in the upcoming months.

I'm hopeful that if I show improvements in the scalp in the upcoming months, that he'll accept me.
------

2 and 7 months on finasteride:
View attachment 40943View attachment 40944


DUPA on back and side:
View attachment 40945View attachment 40946

dang, if that's dupa, then I definitely have dupa. are you certain you don't have Telogen Effluvium? This happens to me every time. I suppose Telogen Effluvium could be defined as temporary dupa in certain cases. Or could this just be an uneven hair cut?

 

[shookwun]

retrograde alopecia. I have it on one side my head also.

 

[M.G]

Did he give you any ideas for next steps for determining the cause(s) of your diffuse loss? How can he know by just inspection whether it's genetic, disease, or some dietary deficiency?

I've already done blood tests and a thyroid-test before this. They all came out normal. Balding runs deep in my family.

dang, if that's dupa, then I definitely have dupa. are you certain you don't have Telogen Effluvium? This happens to me every time. I suppose Telogen Effluvium could be defined as temporary dupa in certain cases. Or could this just be an uneven hair cut?

My back and sides have looked the same since puberty. I started losing hair around my parents divorce, I'm guessing I could've had a Telogen Effluvium from the trauma of that which would've off-set my genetic male pattern baldness. I'm saying this because my brother has a full head of hair at 25 years old (just started thinning a bit) while I'm 21 years old.

retrograde alopecia. I have it on one side my head also.

Nope. He told me right out that I got DUPA. He told me that he saw miniaturizing in the donor.

 

[M.G]

You don't have DUPA.

Why on earth would he check my hair with his tools and measure the thickness/whatever he did and then tell me I got DUPA, if I don't got it?

He specifically said that he would not perform on me the way it is right now, and that he needs to see more improvements on me the next 6+ months if he is gonna perform a surgery on me, because if he does I will have to count to be on finasteride for 10+ years.
------------

The pic of the back of my head is a bit misleading. It looks thicker than what it is in real life.

 

[Swoop]

How old are you?

 

[M.G]

How old are you?

21 years old.
-----------------------------

What kind of finasteride do you guys use?

You think there really is something in that propecia may work better?

 

[TD500]

I can only remember two guys here who claimed they have DUPA. One of them had his hair buzzed so you really couldn't tell and I think he just decided to go slick bald.

 

[jd_uk]

I've also been told before that I have DUPA and a reputable surgeon said I would never be a candidate for a hair transplant in future. I don't think DUPA means going completely bald at the back and sides necessarily...it just means that the miniaturisation at your back and sides is making a transplant risky. The hair isn't good enough quality and could leave gaps and shock loss in the donor.

 

[Swoop]

21 years old.
-----------------------------

What kind of finasteride do you guys use?

You think there really is something in that propecia may work better?

Figured you are very young because he didn't want to operate on you.

Nah.. I mean bio availability may be different across different formulations but this is negligible.

You might consider dutasteride.

 

[M.G]

I've also been told before that I have DUPA and a reputable surgeon said I would never be a candidate for a hair transplant in future. I don't think DUPA means going completely bald at the back and sides necessarily...it just means that the miniaturisation at your back and sides is making a transplant risky. The hair isn't good enough quality and could leave gaps and shock loss in the donor.

jd you have some pics of your sides and back?

Figured you are very young because he didn't want to operate on you.

Nah.. I mean bio availability may be different across different formulations but this is negligible.

You might consider dutasteride.

Perhaps. He quoted me on 5000 grafts for hairline and mid-scalp. Like wtf. 5000 grafts if what you use on NW5-6s. Maybe he wanted to scare me off til I'm older? I know that he usually does much more grafts than other surgeons, but this seems excessive. ********* quoted me for 3200 grafts for the whole scalp from my pics.

Maybe that's why he said come back to me in 6+ months after seeing how finasteride treats my donor over that period.

I probably will try out dutasteride if I would somehow lose progress on finasteride.

 

[LeonardoM]

Hi M.G, I know that you talk that you have DUPA, although it dosen't seem. My case, on the sides of head are really thinin. I looking for someone how makes treatament to know if have any improvement...

Sorry for my bad english.

 

[sunchyme1]

thats some f*****g aggressive hairloss op at 21

f*** me

my condolences

hows it going now?

 

[ManinBlack]

I was under the impression that DUPA was a separate type of hair loss where you just went thin all over and it was different from male pattern baldness and that if you have recession and male pattern baldness then you don't have DUPA. Can you have both?

 

[Grasshüpfer]

I guess I have both.
I have basically the same thickness all over my head, with a slightly weaker crown.

This is what it looks like before shower, after the sides look completely normal.

 

[Grasshüpfer]

Also seven months on finasteride. Photos look about the same, not sure what's going on.

 

[Pacey123]

I think i have dupa too, had miniaturided hair in my donor and at my sides before minoxidil and finasteride, but the donor thickened up very well.

 

[hanginginthewire]

retrograde alopecia. I have it on one side my head also.

How does the retrograde factor in to the long term plan with your transplants? Where are you retrograde?

 

[camille leprevost]

Hello, just to recap, I am a man and have DUPA hair loss (or female pattern hair loss), diffuse hair loss and thinning (back, sides and top) which started 3 years ago after an episode in my life where my alimentation was very bad and had nutrient deficiency for sure. After fixing my alimentation properly my hair are still shedding and thinning all over.

Since 8 month i only take 1mg finasteride / day (no reduction on my hair loss), cb0301 30mg topicaly with no reduction on my hair loss, Biotin (10mg/day), spearmint tea (4 cup/day to reduce free testosterone), Flaxseed (30 g/day to reduce testosterone)

Here is a complete blood test that I have done 3 weeks ago. It would be great if some of you may highlight some issue in it and maybe propose corrective action as he might help others with similar hair loss.

From my perspective, I think I have low zinc, low vitamin d, high prolactin level, high cortisol level and maybe iron deficiency as we can have it according to study even with normal level of blood iron.

BLOOD TEST of the 04.12.2020

Vitamin B12 : 812 ng/l (197-771)
Vitamin A : 0.5 mg/l (0.1-1)

IONIC BALANCE

Sodium : 139 mmol/l (136-145)
Potassium : 4 mmol/l (3.5-4.5)

PROTEIN

Albumin : 47 g/l (40-49)

RENAL FUNCTION

Urea : 46 mg/dl (17-48)
Creatinine : 0.94 mg/dl ( 0.7-1.2)
DFG (CKD-EPI) >90 mL/min/1.73m^2

LIVER/PANCREAS

AST(GOT) : 16 UI/L (<40)
ALT(GPT) : 10 UI/L (<41)
alkaline phosphatase : 55 UI/L (40-129)
Gamma GT : 10 UI/L (10-71)
LDH : 178 UI/L (135-225)
Biribulin total : 0.8 mg/dl (<1.2)
Biribulin conjugated : 0.3 mg/dl (<0.2)

CARDIOVASCULAR RISK FACTOR

Triglyceride : 68 mg/dl (<150)

CARBOHYDRATE METABOLISM

Fasting glucose level : 96 mg/dl (70-100)
Insulin : 39.7 mg/dl (17.8-173)
Index HOMA1-IR : 1.4 pmol/l (<2.4)

TYROID

TSH : 1.35 mu/l (0.27-4.20)
T4 libre : 17.8 pmol/l (12-22)

ADRENAL GLAND

Cortisol (morning test) : 480 nmol/l (166-507)

CALCIUMPHOSPHATE METABOLISM

Bioactive PTH (3nd gen) 25.5 ng/l < 49
25 OH vitamin D : 14.8 μg/l (30-80)

ENDOCRINOLOGY

Total prolactin : 18.2 μg/l (4-15.2)
Bioactive prolactin : 14.9 μg/l (3-11.6)
LH : 5.8 UI/L (1.7-8.6)
FSH : 1.9 UI/L (1.5-12.4)
Oestradiol : 30 ng/l (25-52)
Progesterone : 0.24 μg/l < (0.15
17OH-Progesterone : 3 ng/ml (0.9-3.4)
total Testosterone : 20.80 nmol/l (8.64-29)
Testosterone free: 509.1 pmol/l (260-740)
Androstanediol glucoronide 2.8 nmol/l (4-75)
Delta 4 androstenedione : 1.4 ng/ml (0.1-3)
DHEA-S : 4.72 μmol/l (4.34 – 12.20)
SHBG : 24 nmol/l (18.3-54.1)
DHT : I don’t have the result yet

TOXICOLOGY

Zinc : 72 μg/dl (80-120)

BLOOD

Haemoglobin : 16.6 g/dl (13-18)
Red blood cell : 5.40 10^6/μl (4.40-5.90)
Hematocrit : 45.5% (40-53)
mean corpuscular volume : 84 fL (80-100)
mean corpuscular HB : 30.6 pg (26-34)
mean corpuscular haemoglobin concentration : 36.5 g/dl (31-35)
anisocytose indice : 12% (11.5-13.4)
platelet : 208 10^3/ μl (150- 440)
mean platelet volume : 10.1 fL (8.9-12.9)
white blood cell : 7.16 10^3/ μl (3.5-11)
neutrophiles : 62.1% (40-75)
neutrophiles (absolute): 4.44 10^3/ μl (1.5-6.7)
Lymphocytes : 25.4% (20-45)
Lymphocytes (absolute) : 1.82 10^3/ μl (1.2 – 3.5)
Monocytes : 10.6 % (2-10)
Monocytes (absolute) : 0.76 10^3/ μl (0.2 - 1)
Eosinophiles : 1.5% (2-10)
Eosinophiles (absolute) : 0.11 10^3/ μl (<0.4)
Basophiles : 0.4% (0-1)
Basophiles (absolute) : 0.03 10^3/ μl (<0.1)

INFLAMMATORY SYNDROM

Crp : <0.5 mg/dl (<5)

ANEMIA

Iron : 134 μg /dl (65-175)
Transferrin : 216 mg/dl (215 – 365)
Transferrin saturation : 44% (16-44)
Ferritin : 120 μg/l (30-300)
Folic acid : 4.8 μg/l (>4.6)
Folic acid erytrocytaire : 754 μg/l GR (523-1257)