The mistery of DUPA and the complete lack of information.

[Johnson40]

I know as it's rather rare you're not bound to find plethora of research and case study of that conditions but the absolute void of information is pretty weird for a conditions that seems to contradict current views.
I couldn't find anything but Rassman's paper about DUPA, in legit scientific sources, and absolutely nothing about modes of actions and causes, just vague guideline for transplant surgeon.
I have seen that some physicians and hair restoration expert, vaguely recommend medical treatment, but without much to back it up; quite frankly most of the recommandation seems to be accompanied with a disinterested shrugs, because all those Doctor never seemed to care to show or write about this condition compared to classic male pattern baldness or other types of hair loss.

If DUPA have androgenetic causes why does anti-androgen have such a poor effect? Rassman himself said only half of DUPAs respond to Finasteride ( Keep in mind that one might have both male pattern baldness and DUPA according to him ).

If DUPA is not androgenetic alopecia, why does hair miniaturize? Are there any other conditions which causes hair to miniaturize in such fashion besides Androgenetic Alopecia?

Have anyone ever seen a success story from a DUPA sufferer? We've all seen guys gaining back one or norwood and a half, but i've never seen someone diagnosed with a pure DUPA ( Absolutely no pattern and equal loss of density all around ) have success with anything on the internet.

Does anyone here have ideas, success stories or theory about that sh*t?

 

[DarkHairHair]

I have dupa man and its sucks . I dont know what to do honestly.

I am on fina since 1 years but its not working

 

[Johnson40]

I have dupa man and its sucks . I dont know what to do honestly.

I am on fina since 1 years but its not working

How was your DUPA diagnosed? Did you get some blood work done?
I feel like there could be more to DUPA, but i'm not aware of any other conditions that cause miniaturization like that, because the vast majority of guys on the internet does not seems to respond to duta or finasteride.

 

[DarkHairHair]

How was your DUPA diagnosed? Did you get some blood work done?
I feel like there could be more to DUPA, but i'm not aware of any other conditions that cause miniaturization like that, because the vast majority of guys on the internet does not seems to respond to duta or finasteride.

I diagnosed it myself when I saw holes all over the sides and back of my head. It's exactly the same as what you find in pictures on the internet

And no bloodwork was done.
You have dupa also ?

 

[Johnson40]

I diagnosed it myself when I saw holes all over the sides and back of my head. It's exactly the same as what you find in pictures on the internet

And no bloodwork was done.
You have dupa also ?

Clear cut holes usually indicates alopecia areata, but i guess you weren't reffering to that kind of holes.

Yeah i think i have DUPA, absolutely no recession or pattern, just uniform miniaturization across the whole head, confirmed by my 20$ usb microscope for what its worth.

 

[Selb]

Dupa, retrograde are both androgenic. It just means you have very few dht resistant hairs. As for why dupa is more treatment resistant it’s because finasteride is probably too weak. Oral min, oral dutasteride, and RU are what you probably need to reverse DUPA.

 

[DarkHairHair]

Dupa, retrograde are both androgenic. It just means you have very few dht resistant hairs. As for why dupa is more treatment resistant it’s because finasteride is probably too weak. Oral min, oral dutasteride, and RU are what you probably need to reverse DUPA.

I have never seen success story from dupa suffers , Its suck

 

[Johnson40]

Dupa, retrograde are both androgenic. It just means you have very few dht resistant hairs. As for why dupa is more treatment resistant it’s because finasteride is probably too weak. Oral min, oral dutasteride, and RU are what you probably need to reverse DUPA.

It doesn't make much sense, why would finasteride be too weak for DUPA but not for other form of Androgenetic Alopecia, regardless of agressivity?
Also i recall seeing a post by Rassman saying that Duta didn't worked either, he himself doubt it have completely androgenic cause.

It seems people assume it's androgenic because of the miniaturization, but i have seen no study confirming that.
Also the fact that it's often associated with retrograde alopecia show that this condition does not interest much people besides transplant surgeon.

 

[BetaBoy]

It doesn't make much sense, why would finasteride be too weak for DUPA but not for other form of Androgenetic Alopecia, regardless of agressivity?
Also i recall seeing a post by Rassman saying that Duta didn't worked either, he himself doubt it have completely androgenic cause.

It seems people assume it's androgenic because of the miniaturization, but i have seen no study confirming that.
Also the fact that it's often associated with retrograde alopecia show that this condition does not interest much people besides transplant surgeon.

Does it actually cause cycle on cycle HF miniaturisation or does it just reduce the quantity of anagen hairs/cm2 like in thyroid related alopecias? DUPA is an odd one but if it actually does cause progressive miniaturisation that makes a pretty solid case for it being androgenic in nature.

 

[JaneyElizabeth]

Does it actually cause cycle on cycle HF miniaturisation or does it just reduce the quantity of anagen hairs/cm2 like in thyroid related alopecias? DUPA is an odd one but if it actually does cause progressive miniaturisation that makes a pretty solid case for it being androgenic in nature.

I might have it and male pattern baldness like Rassman conjectures but I am not convinced that Dupa is actually a thing. In my case it made my fringe, which has always been decently high, much more wispy in character but everything is still covered. I microneedle my entire scalp and this might help. Estradiol works best generally for any sort of XY hair woes and the fringe never used to grow long and now it's down to my shoulders in back and down past my ears on the sides==by far the longest my hair has ever been because I had a Marine Corp father who used the electric shears on me over newspaper sections. Boy, did my crew cut go with my Beatles fascination.

"Not in my house. You can wear your hair long in college." As if. Bastard.

 

[Selb]

It doesn't make much sense, why would finasteride be too weak for DUPA but not for other form of Androgenetic Alopecia, regardless of agressivity?
Also i recall seeing a post by Rassman saying that Duta didn't worked either, he himself doubt it have completely androgenic cause.

It seems people assume it's androgenic because of the miniaturization, but i have seen no study confirming that.
Also the fact that it's often associated with retrograde alopecia show that this condition does not interest much people besides transplant surgeon.

Aggressive hair loss in general is treatment resistant, normal male pattern baldness or not. So assuming DUPA implies an underlying aggressive version of male pattern baldness it’ll be treatment resistant.

Think of it like this. 90% of male pattern baldness sufferers respond to finasteride. But that doesn’t account for aggression. Maybe there are 20% of male pattern baldness sufferers that have aggressive hair loss. And a portion of them might be in that 90% response group. But maybe half are in that group that don’t respond. So if DUPA follows that trend, half of them will respond and half won’t.

 

[creatinemonster]

Hey op. I understand your frustration.

I'm a dupa sufferer as well. I 100% think dupa is largely genetic. My dad and other brother has it and I can see the diffusing easily.

I started getting hairloss after Accutane at 18 years old and I then decided to start taking finasteride at 19 years old for preventative measures.

It was very weird, seeing the sides and back of my hair being reduced to a few wispy strands.

I'm now 26 and still on the same protocol of 1mg finasteride. I regrew back a bit of the diffused side hair and back but not that much.

Now I will say, I would look much worse if I hadn't taken finasteride and I highly recommend taking it if you don't get side effects.

The past few years I've been losing ground everywhere and I've been quite sad about that.

Until a few months back when I had covid, I decided to try out an immunostimulant called isoprinosine (inosine pranobex) and I noticed my hair was thickening up everywhere, and even my barber told me that himself.

I then researched and found out it helps with fringe alopecia type hairloss such as alopecia areata and diffuse type hair loss and I then took it for 3 months and I think I regrew a lot of hair for sure.

I wish I can buy more, but it's really hard to buy this stuff and it's out of stock almost everywhere due to people taking it for covid etc.

My advice is to take finasteride and start dermaneedling once a week, and try inosine for a few months and I think you'll be quite satisfied with the results.

 

[danielx111]

I suffer DUPA myself, battle of years but my situation is quite different, I went too far.

I started to lose my hair when I was 16, I took Propecia at the age of 16.5 -19.5, didn't do anything (And even if it did, it didn't do much at all).

At the age of 21 I switched to hair piece. No one know I am wearing and made it extremely undetectable.

I did notice by the age of 21 that I am also shedding in my sides/back etc. Something to mention, I haven't lose hair in my sides until I lost 80-90% hair in top of my scalp.

Then I was like : "I solved my biggest fear with 100% natural hair piece and now I am losing the hair in my entire scalp wtf"????

I didn't know what to do, today I am 28, I am still losing tons of hair in my donor/nape etc etc, it's definitely got thinner but remained in good condition that I can still wear hair piece and make it undetectable.

Something I noticed, when I was 18, I did temporary SMP which did basically nothing because I had to come for touch up every 2 weeks but after 2-3 months my shedding has stopped completely. I thought I was imagining and then 6 years later when I was 24 I did FUE hair transplant (Yes, I know it's a big mistake to do hair transplant when you suffer from DUPA), however I did only 400 grafts to build my template points since it's necessary to pull hair piece and after the FUE, again, my shedding in my donor has stopped for 2 months.

The only common things between those too is the blood that came into my scalp (From the SMP needling and six years later from the anesthesia injection).

I decided to give derma pen a chance a month ago and see if it may stop my hairloss, which I know is basically impossible but because I did experience twice in my life zero shedding (And I shed hundreds of hairs a day just from my donor scalp), I thought it would work.

I am in the third session so far, no decrease in shedding but do have little hope.

My only fear now is to become COMPLETELY bald in my sides but does it even possible? DUPA doesn't stop somewhere? Looking at my six uncles, 10 cousins they are all bald Norwood 6/7, some of them have thinning sides but no one became completely bald like at top.

hopefully more people would speak about DUPA, I have been reading about it since I was like 20 and there's barely any info on the internet.

 

[French]

I'm dupa too and i tried high dose of cyproteron for 9 month, do nothing for my hair, same shedding, same aspect

3 years on Fina, same shedding, same aspect


I think DUPA IS NOT androgenic alopécie

 

[French]

Can i have link for website selling inosin pranobex plz ?

 

[Johnson40]

There's a fair number of reasonable argument on each side, one the fact that hair follicle actually miniaturize in a similar fashion to Androgenetic Alopecia indicate androgenic causes, but the lack of pattern similar to effluvium, deficiency and inflammation related hair loss and the ineffectiveness of antiandrogenic treatment indicates other causes.

One thing possible is that everyone could be talking about different type of hair loss, unlike Norwood pattern Androgenetic Alopecia, from just photographic evidence, DUPA have a boatload of mimickers, and a lot even under a dermatoscope.

Chances are, we may actually talk about conditions that closely ressemble each other, some may be androgenetic, some may be misdiagnosed known conditions and some may just be unknown stuff.

 

[DarkHairHair]

Hey op. I understand your frustration.

I'm a dupa sufferer as well. I 100% think dupa is largely genetic. My dad and other brother has it and I can see the diffusing easily.

I started getting hairloss after Accutane at 18 years old and I then decided to start taking finasteride at 19 years old for preventative measures.

It was very weird, seeing the sides and back of my hair being reduced to a few wispy strands.

I'm now 26 and still on the same protocol of 1mg finasteride. I regrew back a bit of the diffused side hair and back but not that much.

Now I will say, I would look much worse if I hadn't taken finasteride and I highly recommend taking it if you don't get side effects.

The past few years I've been losing ground everywhere and I've been quite sad about that.

Until a few months back when I had covid, I decided to try out an immunostimulant called isoprinosine (inosine pranobex) and I noticed my hair was thickening up everywhere, and even my barber told me that himself.

I then researched and found out it helps with fringe alopecia type hairloss such as alopecia areata and diffuse type hair loss and I then took it for 3 months and I think I regrew a lot of hair for sure.

I wish I can buy more, but it's really hard to buy this stuff and it's out of stock almost everywhere due to people taking it for covid etc.

My advice is to take finasteride and start dermaneedling once a week, and try inosine for a few months and I think you'll be quite satisfied with the results.

Inosin pranobex seems to be the only hope for dupa suffers. Did you notice some regrowth with it ?

 

[Rjgroto]

I was recently diagnozed with dupa as well. I have thinning on the sides though not on the back and It is really odd because i respond very well to treatment (finasteride from 1998 - 2010 and dutasteride from 2011 - up to now). I went to a world class surgeon who said I could only extract follicles from the back, not from the sides. But how can he garantee this condition won't develop into the back.

 

[Grim]

I think some cases of dupa are actually people suffering from diffuse thinning with retrograde. The success or moderate success I have seen in Dupa sufferers is SMP and oral minoxidil because it'll affect the whole scalp and at least some form of dht blocker. I once heard of a dupa sufferer adding a small amount of estrogen and saw success. However that is risky. But I heard a transplant surgeon mention dupa was more common in females than males. Perhaps there is some link to estrogen in regards to dupa. If someone is suffering from dupa I hope they will check their estrogen levels. Even males need a certain amount of estrogen. I just think its interesting to think about.

 

[Grim]

To add, I sometimes look at the transgender transformations on reddit. And I've seen some dupa sufferers reverse their thinning. I really hope one day we'll be able to nail down how to effectively treat dupa.