Diffuse Unpatterned Alopecia (DUPA) Hair Loss — Causes, Symptoms & Treatments

DUPA (Diffuse Unpatterned Alopecia) is a relatively uncommon type of hair loss that does not follow a specific pattern. DUPA hair loss causes overall thinning, resulting in a loss of hair density and coverage. Continue reading this article to learn more about DUPA, including possible causes, symptoms and treatments.
Dr Epameinondas Bonaros in scrubs with his arms folded at the Glasgow clinic

Hair Transplant Surgeon · GMC No. 7566786, ABHRS Diplomate

Receding hairline and crown thinning typical of androgenetic alopecia

What is DUPA Hair Loss?

DUPA is a genetic hair loss condition characterised by hair thinning across the entire scalp. Unlike diffuse patterned alopecia (DPA), DUPA does not follow a specific hair loss pattern.

Rather, it results in distributed thinning, which can appear similar to that of telogen effluvium (temporary shedding of hair follicles in the resting phase of the hair cycle).

DUPA Hair Loss Symptoms

Diffuse unpatterned hair loss can affect both men and women and results in miniaturised hairs across the entire scalp. During this process, patients experience:

  • Hair thinning.
  • Shorter hair length.
  • Lack of density and minimal head coverage.
  • Affected areas include the front, top, sides, and back of the scalp.

DUPA differs from diffuse pattern alopecia, which only affects the front and top of the scalp.

 

What Causes DUPA?

Not much is known about the underlying causes of DUPA besides the fact that it is a genetic condition.

Below is an overview of this, as well as several other external factors that could potentially contribute to DUPA.

Genetics: As with male pattern baldness and other hereditary hair loss conditions, certain patients can be genetically predisposed to DUPA. This means that your family history plays an important role in determining how likely you are to develop DUPA.

For example, if you have relatives with DUPA, you have an increased chance of developing it too. 

Hormonal imbalances: Hormonal changes such as an increase in dihydrotestosterone (DHT) levels can lead to increased hair shedding. This is thought to be linked to diffuse, unpatterned hair loss.

Nutrition: Crash dieting and other unhealthy eating habits can often lead to a lack of essential vitamins and nutrients. This can impact healthy hair growth and result in hair thinning and reduced hair density, both of which are key symptoms of DUPA.

Diagnosing DUPA

When diagnosing the cause of a patient’s hair loss, specialists will usually:

  1. Perform a physical examination.
  2. Conduct various diagnostic tests, such as a scalp biopsy.

For DUPA patients, the results will show hair follicle miniaturisation or changes in diameter that occur across the scalp without a discernible pattern.

Once you have been diagnosed with unpatterned diffuse alopecia, your doctor can recommend a suitable DUPA treatment plan for your needs. This professional medical advice will help ensure the most successful DUPA hair loss recovery process possible.

DUPA Hair Loss Treatment Options

When treating DUPA, remember that different types of hair loss require specific treatment methods. For example, hair transplantation is a common solution for patients with male pattern hair loss.

However, for patients with DUPA, hair transplant surgery is not a viable option. A person diagnosed with DUPA lacks what is known as a stable permanent zone, an area of the scalp unaffected by hair loss that can be used to harvest donor hair follicles.

If a DUPA patient undergoes hair transplant surgery, the procedure will most likely be unsuccessful in the long term. This is because there is a high chance that the transplanted hair will miniaturise and thin over time. Their unsuitability for hair transplantation is a key reason why it is important for patients with unpatterned diffuse hair loss to receive a proper diagnosis.

FAQ

DUPA Hair Loss - FAQs

What’s the difference between DUPA and male or female pattern hair loss?

Both DUPA and male and female pattern baldness (also called androgenetic alopecia) are forms of hereditary hair loss.
However, some major differences between these two conditions include the following: 

Pattern of Hair Loss: 

  • DUPA is characterised by diffuse hair thinning across the entire scalp, affecting various areas without any pattern. 
  • Androgenetic alopecia hair loss follows a set pattern. This typically involves a receding hairline and thinning at the crown (for men) or diffuse thinning on the top of the head (for women). 

Treatments: 

  • DUPA treatments typically rely on medication. The lack of an unaffected donor area means a patient with DUPA is not a suitable candidate for hair transplantation. 
  • Treating androgenetic alopecia can involve hair loss medications, a hair transplant procedure, or a combination of both.

DUPA is not an age-related condition, meaning there is no set time during which it develops. However, patients usually begin to experience signs of DUPA during early adulthood (from their late teens onward). If misdiagnosed or left untreated, the miniaturisation of a patient’s hair follicles will become more pronounced over time.

 

Please feel free to get in touch with our hair restoration clinic for more information about DUPA and other hair loss types.

 

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