Advanced Hair Loss Diagnosis in Houston & Katy: Case Study on Male Pattern Baldness with Scalp Biopsy
When Hair Loss Persists Despite Treatment: A Houston & Katy Case Study
Hair loss can be frustrating—especially when you’ve tried everything from topical solutions to hair transplants and still see thinning. At Reena Jogi MD, serving Houston and Katy, Texas, we specialize in advanced diagnostics and tailored treatment plans for complex cases of hair loss.
Patient Case Summary
A 41-year-old male presented to our dermatology clinic with gradual, moderate hair loss that had been ongoing for several years. Despite two prior hair transplants (in 2020 and 2024), eight platelet-rich plasma (PRP) sessions, oral and topical finasteride, minoxidil, and at-home laser therapy, he continued to experience diffuse thinning.
His family history revealed maternal hair loss, though it appeared to skip generations. He expressed interest in more aggressive treatment options, including dutasteride, and requested a scalp biopsy to rule out scarring alopecia.
Exam & Findings
Scalp exam & trichoscopy: Showed variation in follicle sizes with miniaturized hairs, a hallmark of androgenetic alopecia (male pattern hair loss).
No inflammation or scarring — making autoimmune alopecia less likely.
Plan: Perform a 4mm punch scalp biopsy to confirm diagnosis and exclude scarring forms of alopecia.
Why a Scalp Biopsy Matters
While many cases of hair loss can be diagnosed by physical exam, a biopsy is sometimes essential—especially when:
Hair loss continues despite treatment
There’s a need to rule out inflammatory or scarring conditions
The patient has undergone prior transplants, where scar tissue may complicate diagnosis
Treatment Plan
The patient will continue his current regimen until biopsy results return, at which point we may adjust therapy. Potential next steps include:
Transitioning to dutasteride for stronger DHT suppression
Continuing PRP or exploring AlmaTED therapy
Optimizing topical and oral minoxidil dosing
Counseling provided on:
Risks/benefits of finasteride, dutasteride, and oral minoxidil
Long-term nature of androgenetic alopecia
Importance of realistic expectations after transplant surgery
Understanding Male Pattern Hair Loss
Androgenetic alopecia affects millions of men, often starting with thinning at the crown or temples. It is genetically driven, progressive, and best managed with early intervention. Treatments can slow or even partially reverse thinning, but ongoing maintenance is critical.
Takeaway
If you’re experiencing hair loss despite treatments or surgery, advanced diagnostics like scalp biopsy can help identify the underlying cause and guide more effective therapies.
📍 Serving patients in Houston & Katy, Texas — Dr. Reena Jogi offers expert evaluation and advanced hair restoration options.
📞 Call us today to schedule your consultation and take the next step in your hair restoration journey.
