29-Year-Old Male Follow-Up on Dutasteride for Androgenetic Alopecia | Reena Jogi MD Dermatology in Houston & Katy, Texas
Androgenetic alopecia (AGA), or male pattern hair loss, is a progressive condition that requires consistency and long-term management. A 29-year-old male returned to Dr. Reena Jogi, board-certified dermatologist in Houston and Katy, Texas, for follow-up evaluation after beginning dutasteride 0.5 mg daily several months earlier.
The patient reported no adverse effects from medication but noted continued shedding, prompting further discussion of treatment options and expectations.
Case Overview
Chief Complaint
Ongoing hair shedding
Follow-up for androgenetic alopecia
History of Present Illness
At his previous visit in November 2024, the patient began dutasteride 0.5 mg daily, a potent 5-alpha-reductase inhibitor used to slow genetic hair thinning.
During this follow-up:
He reported no side effects
Continued to experience shedding, which led him to shave his hair very short
He had discontinued topical minoxidil due to lack of perceived benefit
He expressed hesitancy about starting oral minoxidil because of concerns about cardiovascular side effects
A dermatoscopic exam confirmed ongoing non-scarring, patterned hair loss consistent with AGA.
Diagnosis
1. Androgenetic Alopecia (Male Pattern Hair Loss)
Code: L64.8
Findings included diffuse thinning across the scalp, fitting the classic pattern of male genetic hair loss involving the vertex and frontotemporal regions.
2. Photoaging (Dermatoheliosis)
Code: L57.8
Sun-related skin changes were noted, including mild solar elastosis.
Treatment Approach
⭐ 1. Continue Dutasteride 0.5 mg Daily
The patient is tolerating dutasteride well with zero side effects, making continuation appropriate.
Prescription:
Dutasteride 0.5 mg
Take 1 capsule daily
90 capsules, 3 refills
Counseling included:
Possible decreased libido
Mood changes
Decreased ejaculate volume
Gynecomastia
Women who can become pregnant should not handle the capsule
Dutasteride works slowly; visible improvement often takes 6–12 months.
⭐ 2. Considering Additional Therapies
Although the patient does not wish to start oral minoxidil at this time, the following were reviewed:
Oral Minoxidil (Optional for Future)
Start as low as 1.25 mg (½ of 2.5 mg tablet) daily
Risks: swelling, changes in heart rate, dizziness, unwanted hair growth
Reassured patient regarding safety and low dosing
Alma TED
A non-invasive ultrasound-based treatment that:
Improves hair density
Enhances scalp health
Requires no needles or downtime
Patient may consider Alma TED in the future if shedding persists.
Photoaging Management
Retinoid Therapy
The patient was counseled on the benefits of nighttime retinoid use, with instruction to:
Apply a pea-sized amount at bedtime
Wait 30 minutes after washing before application
Use moisturizer if dryness occurs
Recommendations included:
Switch to OTC Differin gel
If sensitive, consider:
Skinbetter AlphaRet Overnight Cream
Alastin Retinol
Daily broad-spectrum SPF 30+ sunscreen was strongly advised.
Patient Education & Expectations
With Dutasteride:
Shedding may continue before improvement occurs
Maximal results appear after 12 months
Genetic hair loss is chronic and requires ongoing treatment
Contact the Office If:
Shedding worsens significantly
New side effects occur
He wishes to initiate oral minoxidil or Alma TED treatments
Follow-Up
A follow-up visit is scheduled in 1 year, or sooner if treatment adjustments are desired.
Expert Male Hair Loss Treatment in Houston & Katy, Texas
At Reena Jogi MD Dermatology, patients receive personalized, evidence-based care for male pattern baldness using advanced medical therapies and state-of-the-art procedures.
Whether you're starting dutasteride, considering oral minoxidil, or exploring options like PRP or Alma TED, our team provides comprehensive, long-term support for maintaining and restoring hair density.
