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What is DUPA (Diffuse Unpatterned Alopecia)?

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by Geoffrey C. Whittaker

Published 07/13/2022

Updated 07/29/2024

Not all hair loss is the same, which means you’re in for very different journeys if you have male pattern baldness or lesser-known alopecias like DUPA hair loss.

DUPA hair loss is a type of hair loss (also known as alopecia) that affects your follicles differently than male pattern hair loss. While we don’t have a ton of information on it yet, we do know that this type of hair thinning commonly shows certain traits and may respond to particular treatments differently than other types of hair loss.

Below, we’ve dug into the many questions you may have and what to do if you’re seeing this type of alopecia in the mirror.

DUPA is an acronym for diffuse unpatterned alopecia — sometimes known as diffuse unpatterned hair loss. Unlike diffuse patterned alopecia or DPA, DUPA affects all of the hair on your head without a specific or predictable pattern.

With male pattern baldness (androgenic alopecia), hair loss commonly occurs around the crown and hairline while everything else stays in place — sometimes called a Norwood pattern.

While it’s also a genetic type of hair loss, DUPA looks more like other hair loss types, such as telogen effluvium, which is caused by health issues and stress, and alopecia areata, which is hair loss caused by an autoimmune condition.

Diffuse unpatterned hair loss has a different shape than pattern hair loss. Otherwise, it is genetically and biologically similar to your standard experience of male pattern hair loss.

Research shows that this type of hair loss looks more like shedding — your hair thins in all areas of the scalp, unlike usual androgenetic alopecia patterns.

In other words, DUPA is distinguished from male pattern baldness because it affects the entire scalp, not simply the portion of the scalp most commonly affected by balding (the crown and hairline).

There isn’t much information about what causes a man to experience DUPA as opposed to other forms of androgenic alopecia. Genetics largely determine whether your hair follicles go or stay as you age, and there’s no clear understanding of why DUPA occurs versus other patterns of hair miniaturization and hair loss.

While the most common cause of diffuse hair loss is telogen effluvium, DUPA is not temporary or caused by stress, illness, trauma, surgery, or other shocks to your mind and body.

So, how do you treat DUPA? Let's start with what doesn’t work: hair restoration and hair transplant surgery.

Studies show that hair transplantation is not an effective treatment for DUPA. That’s because this surgery, which can otherwise address androgenic alopecia symptoms with donor hair, needs quality donor hair follicles to work.

To put it bluntly, someone experiencing DUPA could also eventually lose their hair in the donor area (typically the back of the head or neck). That means your donor area could become sparser, and you may even lose the transplanted hair if those follicles are affected by DUPA.

The only condition in which a hair transplant may be a reasonable treatment is if you accept that your results will be limited in scope.

As for other male pattern baldness treatments like medications, vitamins, and lifestyle changes, limited research suggests that these hair loss treatments and products can help men dealing with genetic or situational hair loss halt — and possibly reverse — the progress of all alopecia forms.

Finasteride

If you’re looking for a treatment approved by the Food and Drug Administration (FDA), one of your best options is finasteride, the generic of Propecia®. This hormone-blocking medication has been shown to treat hormonal imbalances, lower dihydrotestosterone (DHT) levels, and ward off male pattern baldness.

In clinical trials, finasteride has shown general effectiveness against androgenic alopecia — DHT levels can be reduced by 70 percent when you take finasteride as directed by a healthcare provider.

Minoxidil

Topical minoxidil, which you may know as Rogaine®, is believed to stimulate hair growth by improving blood flow to the affected areas of the scalp, which cuts short the latent periods for your hair follicles.

This means they leave the resting phase and start growing again, causing a hefty increase in follicle count and volume.

You can also use minoxidil with finasteride, which leads to even better results for some people.

Hair Vitamins

Adding essential vitamins to your diet or as supplements may also help slow down hair loss.

And while food and supplements are great ways to get vitamins, you might also find them in products like shampoos specifically formatted to fight hair loss. Read more in our guide on what to look for in a men’s hair loss shampoo.

Whether your hair loss has a diffuse pattern or no pattern, there’s one approach you need to take to treatment: involve a healthcare provider in the process.

Hair loss — regardless of what type it is — shouldn’t be handled alone.

A dermatologist or other healthcare professional can diagnose whether you have DUPA, and recommend or prescribe approved treatment options to stop hair loss and attempt to roll back the damage.

Whether getting your hair back is possible is another question, but it’s not one you can answer without support.

If you’re ready to get support for hair loss now, consider using our resources — talk to a healthcare professional now, and dispose of DUPA hair loss today.

7 Sources

  1. Badri T, et al. (2021). Minoxidil. https://www.ncbi.nlm.nih.gov/books/NBK482378/.
  2. Marks, L. S., et al. (2001). Tissue effects of saw palmetto and finasteride: use of biopsy cores for in situ quantification of prostatic androgens. https://pubmed.ncbi.nlm.nih.gov/11337315/.
  3. Rafi, A. W., & Katz, R. M. (2011). Pilot Study of 15 Patients Receiving a New Treatment Regimen for Androgenic Alopecia: The Effects of Atopy on AGA. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262531/.
  4. Singh, M., & Acharya, A. (2021). Overview and Algorithmic Approach to Management of Male and Female Pattern Hair Loss. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719953/.
  5. True R. H. (2021). Is Every Patient of Hair Loss a Candidate for Hair Transplant?-Deciding Surgical Candidacy in Pattern Hair Loss. https://pubmed.ncbi.nlm.nih.gov/34984081/.
  6. Werner, B., & Mulinari-Brenner, F. (2012). Clinical and histological challenge in the differential diagnosis of diffuse alopecia: female androgenetic alopecia, telogen effluvium and alopecia areata--part II. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3699921/.
  7. Zito PM, et al. (2022). Finasteride. https://www.ncbi.nlm.nih.gov/books/NBK513329/.
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Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Knox Beasley, MD

Education

Training

Certifications

Medical Licenses

  • Dr. Beasley is licensed in all 50 states

Affiliations & Memberships

Specialties & Areas of Focus

  • Hair Loss, Dermatology

Years of Experience

  • 10 years of clinical practice as a Dermatologist

Previous Work Experience

  • Medical Director - YouHealth Medical Groups, 2025–

  • Private practice, 2024–

  • Chief of Dermatology - , 2023–2024

  • Chief of Dermatology - , 2019–2023

Chief of Dermatology - , 2015–2019

Publications

  • Wilson, L. M., Beasley, K. J., Sorrells, T. C., & Johnson, V. V. (2017). Congenital neurocristic cutaneous hamartoma with poliosis: A case report. Journal of cutaneous pathology, 44(11), 974–977.  

  • Banta, J., Beasley, K., Kobayashi, T., & Rohena, L. (2016). Encephalocraniocutaneous lipomatosis (Haberland syndrome): A mild case with bilateral cutaneous and ocular involvement. JAAD case reports, 2(2), 150–152.  

  • Patterson, A. T., Beasley, K. J., & Kobayashi, T. T. (2016). Fibroelastolytic papulosis: histopathologic confirmation of disease spectrum variants in a single case. Journal of cutaneous pathology, 43(2), 142–147.  

  • Beasley, K., Panach, K., & Dominguez, A. R. (2016). Disseminated Candida tropicalis presenting with Ecthyma-Gangrenosum-like Lesions. Dermatology online journal, 22(1), 13030/qt7vg4n68j.

  • Kimes, K., Beasley, K., & Dalton, S. R. (2015). Eruptive milia and comedones during treatment with dovitinib. Dermatology online journal, 21(9), 13030/qt8kw141mb.

  • Miladi, A., Thomas, B. C., Beasley, K., & Meyerle, J. (2015). Angioimmunoblastic t-cell lymphoma presenting as purpura fulminans. Cutis, 95(2), 113–115.

  • Beasley K, Dai JM, Brown P, Lenz B, Hivnor CM. (2013). Ablative Fractional Versus Nonablative Fractional Lasers – Where Are We and How Do We Compare Differing Products?. Curr Dermatol Rep, 2, 135–143.

  • Siami P, Beasley K, Woolen S, Zahn J. (2012). A retrospective study evaluating the efficacy and tolerability of intra-abdominal once-yearly histrelin acetate subcutaneous implant in patients with advanced prostate cancer. UroToday Int J, June 5(3), art 26.

  • Siami P, Beasley K. (2012). Dutasteride with As-Needed Tamsulosin in Men at Risk of Benign Prostate Hypertrophy Progression. UroToday Int J, Feb 5(1), art 93. ​​https://www.urotoday.com/volume-5-2012/vol-5-issue-1/48691-dutasteride-with-as-needed-tamsulosin-in-men-at-risk-of-benign-prostatic-hypertrophy-progression.html

Why I Practice Medicine

  • Dr. Beasley began doing telemedicine while serving in the U.S. Army, providing dermatologic care for soldiers stationed around the world. This experience sparked his passion for telemedicine and inspired his commitment to expanding access to healthcare for patients across the United States. 

Hobbies & Interests

  • In his free time, Dr. Beasley enjoys cooking, reading, and trips to the beach with his wife and two kids (with sunscreen of course).

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