Androgenetic Alopecia in a 46-Year-Old Female: A Case Report from Katy & Houston, Texas
Hair thinning in women is a common yet emotionally distressing condition. At Reena Jogi, MD, we frequently evaluate and treat women experiencing progressive hair loss using a personalized, evidence-based approach. This case highlights a 46-year-old female presenting with diffuse, non-scarring hair loss consistent with androgenetic alopecia (female pattern hair loss) and outlines the diagnostic and treatment considerations available at our Katy and Houston dermatology offices.
Patient Presentation
A 46-year-old female presented as a new patient with a one-year history of gradual, generalized hair thinning involving the scalp. The hair loss was described as moderate in severity, with noticeable progression over the past six months. She denied associated scalp pain, itching, or inflammation.
The patient had previously undergone laboratory testing, which revealed low iron and low vitamin D levels, both of which can contribute to hair shedding and worsen underlying hair loss conditions. At the time of presentation, she was already taking spironolactone 50 mg twice daily, along with Nutrafol and other hair supplements, but had not yet noticed significant improvement.
Clinical Examination
A comprehensive dermatologic examination was performed, including evaluation of the scalp and hair using dermoscopy. The patient appeared well developed and well nourished, was alert and oriented, and in no acute distress.
On exam, there was diffuse thinning with patterned distribution across the scalp, consistent with female pattern hair loss, including widening of the midline part with preservation of the frontal hairline. No signs of scarring, erythema, or active inflammation were noted.
Diagnosis: Female Androgenetic Alopecia
Based on clinical findings and history, the patient was diagnosed with androgenetic alopecia (AGA), also referred to as female pattern hair loss. This condition is genetically influenced, hormonally mediated, and slowly progressive over time.
To further confirm the diagnosis and rule out other causes of hair loss, a scalp punch biopsy was discussed as an option. Additional laboratory testing was ordered to reassess iron stores, vitamin D, vitamin B12, folate, and overall metabolic status.
Treatment Discussion & Management Plan
A detailed discussion was held regarding available treatment options for androgenetic alopecia, including:
Oral minoxidil
Topical minoxidil (Rogaine)
Spironolactone
Finasteride (post-menopausal patients)
Low-level laser therapy
Hair growth supplements
Platelet-rich plasma (PRP) therapy
AlmaTED regenerative hair treatment
The risks, benefits, expected outcomes, and potential side effects of each option were reviewed in detail. Cosmetic procedures such as PRP and AlmaTED were discussed, including cost considerations and expected timelines for improvement.
After shared decision-making, the patient elected to continue spironolactone at an increased dose of 100 mg twice daily, with close monitoring. She was counseled extensively on medication safety, including potential side effects such as dizziness, menstrual irregularities, breast tenderness, and elevated potassium levels. The importance of avoiding pregnancy while on spironolactone was emphasized.
Follow-Up & Expectations
The patient was advised that female pattern hair loss is chronic and slowly progressive, and that visible improvement often takes 3–6 months of consistent treatment. She was instructed to contact the office if hair loss worsened or if medication side effects occurred.
A follow-up visit was scheduled in three months to review lab results, assess treatment response, and consider additional therapies if needed.
Expert Hair Loss Care in Katy & Houston, Texas
At Reena Jogi, MD, we specialize in diagnosing and treating complex hair loss conditions in women using advanced medical and procedural therapies. If you are experiencing hair thinning or shedding, early evaluation can make a significant difference in outcomes.
📍 Conveniently serving patients in Katy, TX and Houston, TX
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