DUPA – Diffuse Unpatterned Alopecia

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One of the big things in terms of an indication not to do a hair transplant is something called DUPA diffuse on pattern alopecia. Essentially what this is that, you know, Norwood scale is based on the idea that you are losing funnel top temporal crown hair, but you never lose the backside of the scalp. So, for example, a Norwood 7 is someone that is has horse shoe of hair left in the back of the head unless you shaves it of course, but that is the only usable donor hair. The rest of the scalp is actually just not usable because you’re all bald but that donor area even in a Norwood 7 and particularly in Norwood 7 can be miniaturized. They actually could have compromised hairs in that area because it’s been thin thinned out as well. It can also be part of the global hair loss. So, in other words people think, you know, my donor area the back is going to be pristine. It may get smaller over time. I may lose some of my crown and I did a podcast on retrograde hair loss. You could even lose hair coming from the backside of the bottom side and you think well that’s got to be there but there’s this sacrosanct other words safe preserved donor area in the middle of the back side and that will never be touched and that’s absolutely not true and in cases where there is a minuterization or thinning of the donor area that person is not a safe candidate for surgery because those transpire grafts can eventually fall out and unfortunately, I think that is on the rise. I’m seeing a lot of patients in the office that I just don’t think there’s a good surgical candidates because I look at their donor area, but they often times told that they are good surgical candidates because they’re going to a chain or another place where the doctors aren’t meeting them to the salesman that doesn’t have has no idea what they’re doing is trying to sell that person a surgery and it’s really a problematic situation.

So DUPA defuse unppaterned alopecia is definitely one of the huge things that I’m looking for in the donor area to make sure that you are safe candidate to have a surgical procedure.


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