Do I Have DUPA or Alopecia Areata?

29 years old, male. Around 1 1/2 year ago I started thinning all over, except for 3/4 of the neck area (the last inch), but even there i am sure it is somewhat thinner. I probably lost 50% of volume. I shed 50+ hairs just in the shower. We can call it DUPA. Blood analysis are ok: ferritin, diabetes, thyroid, hepathogram.

Now, the thing is that some months ago I had Exclamation-mark hairs. I would see that most of the shorter and thinner hairs in the shower were even thinner at the root (say 30 or 40% thinner). The Average hair was 3 or 4 cm long (1 inch and a half) and this tapered hairs 1 to 3 cm (0.5 to 1 inch). I thought it was just miniaturizating really fast. But now i know they can be a sign of alopecia areata. I don’t have them anymore. Now the roots are thicker than the distal end as it should be in a normal hair. They disappeared after a diet (no dairy, sugar, flour) or by coincidence. I thought I was improving because of that and because the dandruff decreased. But i still shed many hairs and I am still getting worse (maybe at a smaller rate, only maybe).

Is it just DUPA? Can I have DUPA with Tapering hairs? Could be areata? If not, what else should I check for? Considering that i dont have Tapering hairs anymore (maybe some long ones, but it is really not the same), would a scalp biopsy help to know?

Diffuse unpatterned alopecia (DUPA) and alopecia areata are both very rare in men, but I can not tell you what is going on without seeing you. An examination is necessary, so you should see a good dermatologist in your area who should be able to tell the difference.

I wish I could provide more info, but this isn’t something that can or should be diagnosed just based on your description.