I Think I Have a Diffuse Alopecia

Hi Dr. Rassman,

I’m a 20 yr old white male and I’ve seen my beautiful dense hair reduce it’s volume to about 40% over a 7 months period. It all started about a month after I relocated to another city. 2 months ago I went to a dermatologist. She gave me this treatment: Hairgrow 2% Minoxidil, Ducray Sabal shampoo and some vitamins. I don’t think it’s working because I’ve analyzed my scalp and I have less hair than 2 months ago. The thing is, I don’t have MPB but rather a diffuse alopecia. I honestly have no idea what the cause is because I have a healthy life style with balanced meals and workout. My father has MPB so in the worse case I should have developed MPB as well.
I would be forever grateful if you could shed some light on my problem. Thanks in advance.

When you describe a diffuse alopecia, I really do not know what you are seeing. When I describe a diffuse alopecia, I expect to see miniaturization of hair throughout the scalp, including the rim of hair around the sides and back (we call this the permanent hair zone). When miniaturization occurs in the permanent zone in a man, this is a very bad omen for long term deteriorating hair loss, something that is not easily managed with drugs and certainly not transplants. Rather than go into the complex area of the real diffuse alopecias, their diagnosis and management, I would suggest that you get your scalp mapped for miniaturization to find out what is really going on. Is this real? Is this a disease that you are manifesting?