Diffuse hair loss in women splits into two distinct subtypes, and this distinction directly determines the surgical decision.

DPA — Diffuse Patterned Alopecia

Follows a recognizable pattern per the Ludwig scale; follicles at the back and sides (the classic donor zone) remain healthy and DHT-resistant. These patients are good candidates for transplant surgery.

DUPA — Diffuse Unpatterned Alopecia

Loss extends across the entire scalp, including the classic donor zone — there is no reliable reservoir of healthy follicles. An estimated over 50% of women experience DUPA, meaning the majority of these patients are not safe candidates for either FUE or FUT.

How Is It Determined?

Trichoscopy is used to examine the degree of miniaturization in the donor area. Even mild thinning signs in the donor zone itself can indicate DUPA, in which case surgery is not recommended.

Why it matters so much: Transplanting a DUPA patient can further weaken an already fragile donor supply, leading to visible thinning in both the donor and recipient areas over time.