Addressing PCOS-Related Hair Loss and Scalp Health in a 34-Year-Old Female
At Village Dermatology in Katy and Houston, Texas, Dr. Reena Jogi and her team are experienced in managing complex causes of hair loss in women. In this featured case, we examine a 34-year-old woman diagnosed with androgenetic alopecia related to PCOS and seborrheic dermatitis, and the personalized care plan developed to restore scalp health and promote hair regrowth.
Patient Background
This 34-year-old female presented to our clinic with years-long history of moderate, diffuse hair loss that had worsened gradually. She had not tried any treatment prior to her visit. Recently, her OB-GYN diagnosed her with Polycystic Ovary Syndrome (PCOS), and lab work showed elevated total testosterone levels.
In addition to hair thinning, she also suffered from seborrheic dermatitis, a chronic inflammatory scalp condition presenting with flaking and irritation.
Diagnosis and Clinical Evaluation
A detailed dermatologic examination confirmed:
Androgenetic Alopecia (AGA): a genetically driven, hormone-sensitive condition marked by diffuse non-scarring scalp hair thinning.
Seborrheic Dermatitis (SD): evidenced by persistent scalp flaking and inflammation, a common co-condition in patients with scalp hair loss.
Given her PCOS diagnosis and elevated testosterone, the patient’s hair loss was classified as hormonally influenced female pattern alopecia.
Treatment Plan
After thorough discussion of all treatment options—including oral minoxidil, spironolactone, laser therapy, PRP, and AlmaTED—the patient chose to initiate a topical 5% minoxidil solution, applied nightly to the scalp. Minoxidil is FDA-approved for androgenetic alopecia and is known to help prolong the growth phase of hair follicles.
For her seborrheic dermatitis, the treatment regimen included:
Ketoconazole 2% Shampoo: applied 1–3 times weekly to reduce inflammation and yeast overgrowth.
Fluocinonide 0.05% Solution: applied during flares to manage itch and redness.
A structured application schedule and counseling on long-term use of topical steroids were provided to minimize potential side effects.
Lifestyle and Lab Considerations
Although her free testosterone level was not initially available, further labs were recommended including Vitamin D and iron panel. However, Dr. Jogi advised that treatment would likely remain the same regardless of lab outcomes.
The patient’s existing efforts with diet and exercise (due to prior pre-diabetes) were praised and encouraged, as these lifestyle modifications can support hormonal balance and positively impact hair regrowth.
Expected Results and Follow-Up
Hair regrowth with minoxidil typically begins after 3–6 months of consistent use. The patient was counseled that ongoing treatment is required to maintain results. She is scheduled for a 4-week follow-up for seborrheic dermatitis evaluation and a 6-month review for her alopecia.
Dr. Jogi and her team remain committed to supporting patients throughout their hair restoration journey with a comprehensive, compassionate, and individualized approach.
Trust Houston’s Hair Loss Experts
If you're struggling with hair loss related to PCOS, female pattern hair thinning, or scalp inflammation, schedule a consultation with Reena Jogi, MD, a board-certified dermatologist specializing in hair and scalp disorders in Houston and Katy, Texas. Our integrative, evidence-based treatments are designed to address the root cause and restore confidence.
