Case Report: Early Male Hair Loss in a 44-Year-Old with Androgenetic Alopecia and Telogen Effluvium
At our dermatology clinics in Houston and Katy, Texas, we often see men who notice diffuse hair thinning and are unsure whether it is stress-related or genetic. This case of a 44-year-old male patient illustrates how both androgenetic alopecia (AGA) and telogen effluvium (TE) can occur together, influencing treatment decisions.
Patient Presentation
The patient reported gradual hair thinning for 8 months. He described the shedding as moderate in severity and diffuse across the scalp. He has a family history of hair thinning on his maternal side, which is a common pattern in male patients with androgenetic alopecia.
On exam, he had signs of both patterned hair loss and diffuse shedding. A hair pull test was positive, supporting the diagnosis of telogen effluvium as well.
Diagnostic Considerations
Because androgenetic alopecia is genetically predetermined and progressive, and telogen effluvium is often triggered by stress, illness, nutritional deficiencies, or thyroid changes, the two can overlap. In this case, the patient’s diffuse thinning was most consistent with AGA with underlying TE.
A scalp punch biopsy was discussed as an option to further confirm the diagnosis.
Treatment Counseling
We reviewed a range of treatment options, including:
Oral medications: minoxidil or finasteride (not suitable for everyone)
Topical Minoxidil (Rogaine)
Low-level laser therapy (LLLT) devices such as Theradome
Supplements such as Nutrafol for men, Xtresse, Viviscal, or Votesse
PRP therapy or Alma TED procedures (cosmetic, not covered by insurance)
Hair transplantation for more advanced cases
Patient’s Plan
After extensive counseling, the patient decided to start:
Nutrafol Men’s supplements
Topical Minoxidil 5%
He was also given a lab slip to evaluate possible underlying triggers of telogen effluvium and a handout reviewing treatment options.
Follow-up was scheduled in 6 months to reassess progress.
Takeaway for Patients in Houston & Katy
This case demonstrates how male hair loss can be caused by more than one condition. Early identification of androgenetic alopecia and telogen effluvium allows for a more tailored treatment approach. While genetics drive AGA, addressing stress, illness, or nutritional deficiencies may improve TE-related shedding.
At our Houston and Katy dermatology clinics, we specialize in advanced evaluation and treatment of male hair loss, including medical therapies, supplements, PRP, and Alma TED procedures.
