Case Report: Long-Standing Male Pattern Hair Loss Treated With PRP, Finasteride, and Oral Minoxidil
Hair Loss Specialist in Katy & Houston, Texas – Reena Jogi, MD
Patient Background
A 42-year-old male presented as a new patient with concerns of gradual scalp hair loss that had been progressing for over a decade. He described generalized thinning, most noticeable at the crown, with moderate severity and slow onset. The patient also reported a history of scalp itching.
He had previously taken finasteride (Propecia) more than a year ago but discontinued treatment after his primary care physician retired. At the time of presentation, he was not using any active hair loss treatments. He reported a strong family history of hair thinning on both sides of his family, consistent with hereditary hair loss.
Clinical Examination
A focused dermatologic examination was performed, including scalp and hair inspection using dermoscopy. The patient appeared well-developed, well-nourished, and in no acute distress.
Key exam findings included:
Diffuse thinning with patterned involvement of the vertex and crown
Findings clinically consistent with androgenetic alopecia
Hair pull test negative, suggesting chronic rather than active shedding
There was no evidence of scarring alopecia or inflammatory scalp disease on exam.
Diagnosis
Androgenetic Alopecia (L64.8)
Diffuse non-scarring hair loss with patterned hair thinning of the scalp
This presentation is typical of male pattern hair loss, a genetically determined condition that progresses slowly over time and most commonly affects the frontotemporal scalp and vertex.
Treatment Plan
After a detailed discussion of treatment options, risks, benefits, and expectations, the patient elected to pursue a comprehensive hair restoration plan combining medical and procedural therapy.
Medical Treatment
Oral Finasteride 1 mg daily
Oral Minoxidil 2.5 mg daily
The patient received extensive counseling regarding:
Potential side effects of finasteride, including decreased libido, decreased ejaculate volume, gynecomastia, and mood changes
Risks of oral minoxidil, including swelling, dizziness, unwanted hair growth, and cardiovascular symptoms
The importance of long-term, consistent treatment for best results
Platelet-Rich Plasma (PRP) Therapy
Given the chronic nature of his hair loss, the patient elected to begin Platelet-Rich Plasma (PRP) therapy the same day.
PRP Treatment Details:
PRP session #1 performed during the visit
7 cc of PRP injected into the scalp
Procedure performed under sterile conditions
Pain controlled with Zimmer device
No complications noted
The patient was counseled that PRP is a cosmetic treatment not covered by insurance, and that multiple sessions are typically needed for optimal improvement.
Follow-up plan:
PRP #2 scheduled in 1 month
Clinic follow-up in 6 months to assess response
Additional Counseling & Expectations
The patient was counseled that:
Male pattern hair loss is genetically predetermined and slowly progressive
Treatments such as finasteride, minoxidil, PRP, low-level laser therapy, and supplements can slow progression and improve density
Early and consistent treatment offers the best chance of hair preservation
He was advised to contact the office if hair loss worsens or if medication side effects occur.
Expert Hair Loss Care in Katy & Houston, Texas
At Reena Jogi, MD, we specialize in advanced medical and procedural treatments for male and female hair loss, including:
Androgenetic alopecia
PRP hair restoration
Oral and topical hair loss medications
AlmaTED™ regenerative hair therapy
If you are experiencing hair thinning or crown hair loss, early evaluation by a board-certified dermatologist can make a significant difference.
