Why Doesn’t Propecia Work For Dupa or Female Pattern Balding?

In a previous question you said propecia doesn’t work for DUPA. Isn’t DUPA miniaturization of the follicle we see in Aga and FPB. I have seen that most cases of FPB also has some degree of thinning on the whole head, back and sides. I thought it had already been proven that dht caused miniaturization of the follicle. If not DHT then what are the other causes of hair miniaturizing? Actual miniaturization and not just hair falling out like TE or AA. Miniturization of anykind has been said to be the hallmark on diagnosing all AGA. Could it be that it does work at the same percentage as it does in mpb but because we see so much less cases of DUPA and by the time it shows you need to be at the point of 40-50% loss. Is it more a game of not being able to catch up after such loss.

I believe there are some misconceptions here I would like to clear up.

Male Pattern Balding is a genetic condition in men. In other words if a man was born with the gene(s) for MPB, he will have a hair loss in a certain predictable “pattern” (thus the term Male Pattern Balding). Scientist have found if a man has the gene for MPB, a hormone called dihydrotestosterone (DHT) is partially responsible for his hair loss. If a man does not have the MPB gene, DHT will not cause hair loss. Propecia is a drug that block the DHT action and it works in men who have the genes for MPB.

Propecia will not work for DUPA or Female Pattern Balding because hair loss is not a related to DHT and it is not related to the gene for male pattern balding. DUPA (Diffuse Un-Patterned Alopecia) is similar to generalized hair loss in women and as such is not impacted by the drug Propecia (finasteride).

Miniaturization is just a phenomenon seen in the hair loss process. You will see miniaturization in naturally shedding of hair in a non balding person in some of the hairs at the end of their normal cycle. A non balding person will have up to 20% of miniaturized hair (many of them actually vellus hairs that are small, very short hairs found in each follicular unit in all people). Hairs go through natural cyclex of growth and shedding (anagen, catagen, telogen). A person with MPB will likely have more than 20% of miniaturization in a specific pattern around his scalp. A person with DUPA will likely have much more than 20% of miniaturization all over the scalp in a non specific pattern (thus the term Diffuse Un-Patterned Alopecia).