Diffuse Unpatterned Alopecia – DUPA

Patients with Diffuse Unpatterned Alopecia (DUPA) develop hair thinning not only in the front and top of the scalp, but also on the sides and back (the sides and the back of the head are areas that are traditionally considered safe from hair loss). There is diffuse miniaturization of the hair from all over the scalp at the same time. Miniaturization refers to a process wherein the individual strands of hair progressive become shorter and thinner, until they almost disappear.

Very often in DUPA, there is not much hair loss. The hair just begins to thin from all over the scalp. As there is not much hair loss, the patient often does not notice anything amiss. It is the friends or relatives who notice the signs of thinning and bring it to the patient’s attention.

Unlike Pattern Baldness, in DUPA, we see no pattern. The thinning may start from the sides and back of the head, and then may spread all across the head which is also referred in American Academy of Dermatology Association.

DUPA can affect both men and women. The differences have increasingly blurred with passage of time. DUPA is also seen in Chronic Telogen Effluvium where a pre-existing hereditary hair loss condition gets exacerbated due to environmental factors like frequent change of water resulting from traveling or relocating every 1-2 years, long term stress or a chronic illness. The result, the person starts balding in his early 20’s or 30’s instead of the usual thinning seen with advancing age. In women, DUPA is often precipitated by a hormonal trigger. For example post-childbirth & the menopausal phase of life are the commonest triggers.