In diffuse patterned loss, patients experience thinning throughout the frontal scalp, vertex and back crown. All the hairs of this condition undergo miniaturization. However, the sides and the back are spared and preserve the stable “permanent zone. With DPA a well-defined hairline is retained. DPA predominantly affects both male and females.
Unlike male and female pattern hair loss which have a propensity to follow one of the balding patterns as defined by the Norwood scale and Ludwig scale, Diffuse Patterned Alopecia (DPA) is demonstrated as diffuse thinning over the entire front, vertex and crown with no distinguished pattern evident. DPA is also a form of genetic balding condition like androgenetic alopecia. However, a clear difference is that the hair is not completely lost, but rather thins out enough that the underlying scalp becomes visible.
Similar to androgenic alopecia, DPA is also a type of hereditary hair loss that generally runs in families. The most common cause of diffused pattern alopecia is Dihydrotestostero- a byproduct of male hormone testosterone.
DHT collects in the scalp’s tissues, where it may adversely affect the hair follicle only if the patient has a genetic sensitivity to the DHT hormone. Not all individuals are susceptible to DHT, but if such sensitivity exists, then DHT prevents the hair follicle from obtaining nutrients by obstructing its track passage to the blood supply. This shortage of blood flow makes the follicles to shrink (which is also known as “miniaturization”). In DPA, instead of halting to produce, new hairs turn out to be thin and brittle.
Various researches have indicated that when the level of DHT increases, the resulting androgens begin attacking hair follicles. This leads to weakening of the follicles, potentially impacting their competency to grow strong, healthy and lustrous hair.
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DPA is an inherent hair loss problem, which refers that there is no fixed age to catch this disorder. DPA can start to demonstrate itself at any age, but due to an undeniable fact that it is caused by a male sex hormone, it is much more detectable in adult men than women. Women have DHT in their bodies, but their hereditary formation makes them less vulnerable to the destructive effects of DHT on hair follicles.
Women on the other hand are much prone to crop up diffuse unpattern alopecia (DUPA), which is depicted by thinning of hair even in the donor zone as well.
DPA mostly responds substantially to medical hair loss treatments like Rogaine (minoxidil) and Propecia (finasteride) and, due to the conservation of the permanent donor area, many DPA sufferers become eligible candidates for hair transplant surgery.
The extremity of DPA can be lowered down by taking hair stimulating medicines such as Minoxidil and Finasteride. Minoxidil in known to broaden the hair follicle (thickening the hair), stimulating hair re-growth and allows the follicle to enter longer stages of anagen (the growth phase), which sustains a longer time span of active growth. While the Finasteride is an oral pill which works by reducing the effect of Dihydrotestosterone and prevents the 5 alpha-reductase from restraining testosterone into DHT, which can slow down or even arrest the DPA process.
In addition, those suffered by DPA often respond well to surgical treatments like hair transplant. In diffuse patterned alopecia, the back of the scalp remains unaffected and therefore rich in good hairs hair restoration is an ideal option. For this reason, DPA patients are suitable candidates for follicular unit strip surgery (FUSS) and follicular unit extraction (FUE).
In DUPA, patients develop hair thinning not only on the top and front of the scalp, but also at the back and sides. In males with DUPA, the large part of hairs on the scalp is undergoing miniaturization or will later at some point in time.
The significance of identifying DUPA is the fact that hair restoration is not an option. Hairs at the back are not of superior quality to move as they are (or will some time become) miniaturized. If a hair restoration surgery is performed in a patient with DUPA, it may look convincing for a few years, but the restored hairs are at big risk to thin out and be lost with span of time.
DUPA mainly depicts itself on the back and sides of the scalp at first, unlike male pattern baldness, which critically appears at the crown and the hairline. DUPA can at times mimic the signs of male pattern baldness at initial sight, but it shortly distinguishes itself by its promptness and exceptional widespread distribution of hair loss.
As the term implies, DUPA hair loss does not abide by to any single pattern of conventional hair loss, and is majorly responsible for modifications in hair density as against the complete baldness. Fundamentally, it cannot be recognized using the widely recognized Norwood/Hamilton charts, which visually portrays the most common types of hair loss.
Your expert hair dermatologist will be able to observe an equal amount of hair loss across the entire scalp, and will be in a position to rule out any physical or chemical traumas. In budding stages, hair experts may be capable of determining distinctly miniaturized hairs that can signify DUPA by using magnifying tool. In further stages, your hair physician will be competent to tell because the scalp is easily seen, and the hair loss will not fit conventional patterns.
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DUPA is responsible for the hair follicles to miniaturize, to the extent of which the hair follicles shrink to the level that they are not longer able to produce strong, healthy hair. On contrary to diffuse patterned alopecia (DPA), which does not have any impact on hair at the back of the head (called as the occipital area), DUPA on other side causes miniaturization on the top, front, sides and back of the scalp. No area is exempted from miniaturization.
Since the donor region is compromised, hair restorations are not commonly suggested for those suffering with DUPA. A follicular unit transplant (FUT) will simply be ineffective as it needs the hairs to be dissected from the donor region, which is inadequate in this condition.
A follicular unit extraction (FUE) is same as FUT, but it can optimally put hairs to use that are not in the donor region. However, these substitute hairs are generally not in a healthy state because of DUPA, and good chances are there of non-survival. Thus, a FUE procedure attempt on a candidate with DUPA will possibly produce temporary results that will be fully be refuted as the restored hairs surrenders to the androgenic condition.
The only treatment for patients with diffuse unpatterned alopecia (DUPA) is medical treatment – finasteride, low level laser, minoxidil and platelet rich plasma. Men and women can ease off their DUPA signs or symptoms by having finasteride or minoxidil.
The medication though may reduce the rate of DUPA, but it is by no means going to halt or reverse the condition permanently. Presently, there is no permanent resolution program to stop or reverse the damaging impacts of DUPA
DUPA is believed to be an inherent disease, and can take place at any age. However, it is far more widespread amongst females. In fact, DUPA is one of the leading causes of patchy baldness and hair loss in women in normal. Perhaps this is why females are merely noticed balding in the same horseshoe-shaped manner that males with diffuse patterned alopecia tend to.
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