Patients with Diffuse Unpatterned Alopecia (DUPA) develop hair thinning not only in the front and top of the scalp, but also on the sides and back (the sides and the back of the head are areas that are traditionally considered safe from hair loss). There is diffuse miniaturization of the hair from all over the scalp at the same time. Miniaturization refers to a process wherein the individual strands of hair progressive become shorter and thinner, until they almost disappear.
Very often in DUPA, there is not much hair loss. The hair just begins to thin from all over the scalp. As there is not much hair loss, the patient often does not notice anything amiss. It is the friends or relatives who notice the signs of thinning and bring it to the patient’s attention.