Case Report: Androgenetic Alopecia in a 57-Year-Old Female with Medication Intolerance
At our dermatology clinic in Houston and Katy, Texas, we frequently treat women with androgenetic alopecia (female pattern hair loss) who have complex medical histories and prior treatment failures. This case demonstrates the value of a personalized approach when standard therapies are not well tolerated.
Patient Presentation
A 57-year-old woman presented with generalized hair loss that had been gradually progressive for several years. The patient reported a family history of hair loss in an aunt.
Previous treatments included:
Spironolactone – discontinued due to hypotension.
Topical minoxidil – stopped due to an allergic reaction (facial swelling).
Nutrafol supplements – ongoing use.
PRP treatments at a medical spa – with partial improvement.
Oral minoxidil from an outside provider – previously effective.
She is currently taking a GLP-1 agonist for weight management, and we discussed that these medications may occasionally contribute to hair loss.
Clinical Examination
The exam revealed:
Diffuse hair thinning with a widened midline part.
Preservation of the frontal hairline, consistent with female pattern hair loss.
No signs of scarring, scaling, or erythema.
Diagnosis
Androgenetic Alopecia (Female Pattern Hair Loss) – supported by clinical history and examination.
A punch biopsy was recommended for diagnostic confirmation, but the patient elected to proceed with treatment.
Treatment Plan
The patient was counseled extensively on treatment options, including minoxidil, spironolactone, supplements, PRP, low-level laser caps, AlmaTED, and hair transplantation. After reviewing risks and benefits, she elected to:
Restart oral minoxidil 2.5 mg, beginning with ½ tablet daily to reduce the risk of hypertrichosis.
Continue Nutrafol supplements.
Return in 3–6 months for reassessment.
Counseling on oral minoxidil included potential side effects:
Shortness of breath
Swelling of the feet/ankles
Dizziness, lightheadedness
Low blood pressure
Tachycardia or palpitations
Unwanted facial/body hair growth
She has been cleared by her cardiologist to start and continue oral minoxidil. Baseline photographs were obtained.
Conclusion
This case highlights the importance of tailored treatment strategies for women with androgenetic alopecia who cannot tolerate standard therapies. By cautiously reintroducing oral minoxidil at a low dose, while monitoring closely for side effects, we aim to improve hair density and slow disease progression.
If you are experiencing female hair loss in Houston or Katy, Texas, our clinic offers advanced diagnostic evaluations and a wide range of treatments, including oral and topical medications, supplements, PRP, AlmaTED, and hair restoration procedures.
