Case Report: Early Frontal Hair Thinning in a 33-Year-Old Woman With Androgenetic Alopecia
Female Hair Loss Treatment in Katy & Houston, Texas – Reena Jogi, MD
Patient Background
A 33-year-old female presented as a new patient for evaluation of frontal scalp hair thinning that had been present for approximately 6 months. She reported gradual hair loss along the front of her scalp without prior treatment. The patient was otherwise healthy and had not yet tried prescription or over-the-counter hair loss therapies.
Clinical Examination
A focused dermatologic examination was performed, including scalp and facial inspection. The patient had Fitzpatrick Skin Type IV and appeared well-developed, well-nourished, and in no acute distress.
Key exam findings included:
Diffuse thinning along the frontal scalp
Findings clinically consistent with androgenetic alopecia
Hair pull test mildly positive, suggesting early active shedding
No obvious scarring or permanent follicular loss on exam
A punch biopsy was discussed to confirm the diagnosis, but the patient elected to begin treatment first and defer biopsy at this time.
Diagnosis
Androgenetic Alopecia (L64.8)
Patterned hair loss with diffuse non-scarring hair loss of the scalp
This presentation is typical of early female pattern hair loss, which often manifests as frontal or diffuse thinning and can be exacerbated by hormonal factors.
Treatment Discussion & Plan
A comprehensive discussion was held regarding treatment options, including:
Topical and oral minoxidil
Spironolactone
Topical Rogaine®
Low-level laser therapy (laser caps)
Nutritional supplements
Platelet-Rich Plasma (PRP) therapy
AlmaTED™ regenerative hair restoration
The patient was informed that PRP and AlmaTED are cosmetic procedures not covered by insurance. Risks, benefits, and expectations were reviewed in detail.
After shared decision-making, the patient elected to begin:
Medical Therapy
Spironolactone 50 mg twice daily
The patient was counseled on:
Hormonal mechanisms of female pattern hair loss
Potential side effects of spironolactone
The importance of consistent, long-term treatment
When to contact the office if symptoms worsen or side effects occur
Concurrent Scalp Condition: Seborrheic Dermatitis
During the visit, the patient was also noted to have seborrheic dermatitis of the scalp, which can worsen hair shedding and interfere with hair regrowth if untreated.
Treatment Plan for Seborrheic Dermatitis
Ketoconazole 2% shampoo
Lather into the scalp for 5–10 minutes, then rinse
Use 1–3 times weekly for maintenance
Fluocinonide 0.05% topical solution
Apply to scalp twice daily as needed for severe flares only
The patient was counseled on the chronic nature of seborrheic dermatitis, flare triggers such as stress, and the importance of controlling inflammation to optimize hair loss treatment outcomes.
Additional Findings: Eyebrow Hypotrichosis
The patient also noted decreased hair density of the right central eyebrow, consistent with hypotrichosis (L65.8).
Treatment options such as Latisse® and Revitabrow® were discussed
The patient elected to defer treatment at this time
Follow-Up Plan
Return in 4 weeks for seborrheic dermatitis follow-up
Return in 3 months for reassessment of hair loss response
Early intervention offers the best chance to slow progression and preserve hair density, especially in young women with early androgenetic alopecia.
Female Hair Loss Expertise in Katy & Houston, Texas
At Reena Jogi, MD, we specialize in diagnosing and treating complex hair and scalp disorders, including:
Female pattern hair loss
Hormonal hair thinning
Seborrheic dermatitis–associated shedding
PRP and AlmaTED hair restoration
If you’re noticing frontal thinning or increased hair shedding, early evaluation by a board-certified dermatologist is key.
