Addressing PCOS-Related Hair Loss and Scalp Dermatitis in a 34-Year-Old Female
Introduction
Hair loss in women can be emotionally distressing, especially when it appears gradually and worsens over time. At Reena Jogi MD, serving patients throughout Katy and Houston, Texas, we often see women struggling with hair thinning due to a combination of genetic and hormonal factors. This case highlights the comprehensive management of a 34-year-old female patient recently diagnosed with Polycystic Ovary Syndrome (PCOS), who presented with diffuse hair loss and scalp inflammation.
Patient Presentation
A 34-year-old female arrived at our clinic in Katy, TX, with complaints of progressive scalp hair thinning. The onset was gradual and moderate in severity, affecting her confidence and daily life. She reported no prior treatments for hair loss.
Significantly, she had recently been diagnosed with PCOS by her OB-GYN. PCOS is a known contributor to androgenetic alopecia due to elevated androgen levels. Lab work revealed high total testosterone, and she was encouraged to obtain additional lab work including free testosterone, Vitamin D, and an iron panel.
Clinical Examination
Scalp Findings: Generalized thinning consistent with female pattern hair loss (androgenetic alopecia).
Skin Findings: Flaky scalp patches consistent with seborrheic dermatitis.
Mental Status: Patient was alert, well-nourished, and in no acute distress.
Tool Used: Dermatoscope examination confirmed diffuse, non-scarring patterned hair loss.
Diagnosis
Seborrheic Dermatitis (L21.8)
Treatment Plan
For Hair Loss (Androgenetic Alopecia):
Topical Minoxidil 5% Solution:
Applied once daily at night to the scalp.
Patient was counseled to continue long-term use for best results.
Explained initial shedding phase (6–10 weeks) is expected.
Lifestyle Recommendations:
Continue diet and exercise plan due to history of pre-diabetes.
Maintain a healthy lifestyle to stabilize hormonal imbalances.
For Seborrheic Dermatitis:
Ketoconazole 2% Shampoo:
Use 1–3 times weekly; lather for 5–10 minutes.
Fluocinonide 0.05% Solution:
Apply BID as needed for severe flares.
Skincare Advice:
Use emollient shampoos with zinc pyrithione or tar.
Avoid high-potency steroids on facial or sensitive areas.
Patient Education & Counseling
Reviewed treatment options for AGA including:
Spironolactone
AlmaTED ultrasound therapy
Hair supplements (Viviscal, Nutrafol, Votesse)
Discussed that pattern hair loss is chronic but manageable with consistent care.
Patient preferred to begin with topical therapy and revisit more aggressive options later.
Follow-Up Plan
Hair Loss: Reassess in 6 months.
Scalp Dermatitis: Return in 4 weeks for progress evaluation.
Conclusion
At Reena Jogi MD, our goal is to provide personalized, evidence-based care for every patient facing hair loss. In this case, a multifaceted approach was taken to address both the hormonal drivers of androgenetic alopecia and the inflammatory condition of seborrheic dermatitis. Through patient education and targeted therapies, this patient is now on a path toward restored scalp health and improved hair density.
