Understanding Miniaturization vs. CTE(MARK)

[ohnolosingit]

I have asked Dr. R a question and he hasn't answered it.


It has been said many times by Dr. R and Dr. B that it is completely normal to have some degree of miniaturization in the donor areas. I think it was like 10-15%.

My questions is regarding a male with what I believe to be Chronic TE. If this person represents with 30% whole head miniaturization at 40 and diagnosed as non-dupa than how can doctors eliminate CTE as a possible diagnosis. Meaning if you are using the idea that the % of hairs that are miniaturized to diagnosis DUPA or FPB then would it make sense if someone who may fall into the normal % of miniaturization on sides and back would have an LARGE increase of the ratio of miniaturized hair since they have lost a significant amount of hair due to a CTE. This would effected the ratio greatly, thus giving the wrong diagnosis of a higher Min% when in reality there is normal min% but just less hair due to other causes to determine the ratio.

Thanks

[Mark]

You're talking about two different conditions that are both fairly difficult to treat, so what would it matter either way? If it's CTE, it'll likely fix itself on its own and a doctor might prescribe finasteride. If it's DUPA, a doctor would probably prescribe finasteride as well. Either way, they're going to be unable to have a hair transplant.

Or maybe I'm misunderstanding your question? I had to read through that about 5 times to understand what you were getting at.

-Mark

[ohnolosingit]

Sorry I was pretty tired when I wrote that. I can see why you would be confused.

Really my point is that it would be very possible to misdiagnose someone who has CTE and calling it DUPA. I would think it would be a big deal to the patient that it is CTE instead of DUPA, even though the doctor may treat them both with finasteride.

I just thought it is interesting that a CTE could create a diagnosis of DUPA if the person had normal miniaturization in the donor and sides of 10-15%. But it would appear like a higher % due to all the hair loss from the CTE.




You're talking about two different conditions that are both fairly difficult to treat, so what would it matter either way? If it's CTE, it'll likely fix itself on its own and a doctor might prescribe finasteride. If it's DUPA, a doctor would probably prescribe finasteride as well. Either way, they're going to be unable to have a hair transplant.

Or maybe I'm misunderstanding your question? I had to read through that about 5 times to understand what you were getting at.

-Mark

[Mark]

Sorry I was pretty tired when I wrote that. I can see why you would be confused.

Really my point is that it would be very possible to misdiagnose someone who has CTE and calling it DUPA. I would think it would be a big deal to the patient that it is CTE instead of DUPA, even though the doctor may treat them both with finasteride.

I just thought it is interesting that a CTE could create a diagnosis of DUPA if the person had normal miniaturization in the donor and sides of 10-15%. But it would appear like a higher % due to all the hair loss from the CTE.

Exactly. This is why, in cases like you describe, it's never OK to simply go to the doctor once and expect a perfect diagnosis.

Medicine is a field where there is very rarely a 100% correct answer. Only over time can a lot of things be determined for certain.

In this case, CTE could be confirmed or ruled out by evaluating the hair density over time to see how much it changes. With DUPA, it very rarely ever gets better on its own, whereas with CTE it tends to get better by itself.