Androgenetic Alopecia Affecting the Scalp and Beard in a 28-Year-Old Man: A Case Report from Katy & Houston, Texas
Hair loss in young men can involve both the scalp and facial hair, often leading to significant concern and anxiety. Early diagnosis and treatment are key to slowing progression and preserving hair density. At Reena Jogi, MD, we offer personalized, evidence-based care for male pattern hair loss. This case highlights a 28-year-old male with androgenetic alopecia involving the scalp and beard who elected to begin finasteride therapy.
Patient Presentation
A 28-year-old male presented as a new patient with a two-year history of gradual hair loss involving both the scalp and beard. The hair loss was described as generalized and moderate in severity, with slow progression over time.
He denied scalp itching, pain, burning, or scaling and was not currently using any hair loss treatments at the time of presentation.
Clinical Examination
A focused dermatologic examination was performed, including evaluation of the scalp, hair, face, and eyelids. The patient appeared well developed, well nourished, alert, and oriented, with no acute distress.
Examination demonstrated diffuse, non-scarring hair thinning with a patterned distribution, consistent with androgenetic alopecia, affecting the scalp and facial hair regions.
Diagnosis: Androgenetic Alopecia
Based on the clinical appearance and history, the patient was diagnosed with androgenetic alopecia. The diagnosis, genetic basis, and natural progression of male pattern hair loss were reviewed in detail.
The patient was counseled that male androgenetic alopecia commonly affects the vertex and frontotemporal scalp, and in some individuals may also involve beard density changes.
Treatment Discussion & Decision
Treatment options were reviewed extensively, including:
Oral minoxidil
Finasteride
Low-level laser therapy
Hair growth supplements (Viviscal, Nutrafol, Votesse)
After reviewing risks, benefits, expectations, and alternatives, the patient elected to proceed with finasteride therapy.
Medication Plan & Counseling
Finasteride
Finasteride 1 mg tablet
Take one tablet by mouth daily
Comprehensive counseling was provided regarding potential side effects, including:
Decreased libido
Decreased ejaculate volume
Gynecomastia
Mood changes or depression
The patient was reassured that these side effects are uncommon, and many men tolerate finasteride well with good long-term outcomes. He verbalized understanding, and all questions were addressed.
Women were advised not to handle finasteride tablets.
Adjunctive Treatment Recommendations
The patient was also advised to begin:
Rogaine (minoxidil) 5% topical foam, applied twice daily for at least six months
He was counseled that initial shedding may occur when starting minoxidil and that consistent use is required to maintain results.
Alternative non-prescription options such as supplements and low-level laser helmet devices were discussed for future consideration.
Follow-Up & Expectations
The patient was educated that androgenetic alopecia is chronic and slowly progressive, and treatment is aimed at slowing hair loss and preserving density. Improvement is typically assessed over several months.
A follow-up visit in six months was scheduled for reassessment and medication refills.
Expert Male Hair Loss Care in Katy & Houston, Texas
At Reena Jogi, MD, we specialize in treating male hair loss at all stages, including early-onset androgenetic alopecia affecting the scalp and beard. Personalized treatment plans help patients achieve the best long-term results.
📍 Serving patients in Katy, TX and Houston, TX
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