Case Report: Managing Androgenetic Alopecia and Acne in a 39-Year-Old Female
At our dermatology clinic in Houston and Katy, Texas, we frequently see women experiencing both chronic hair loss and acne, conditions that can significantly affect self-confidence. This case highlights the importance of individualized care in managing androgenetic alopecia (AGA) and adult acne.
Patient Presentation
A 39-year-old female presented for evaluation of generalized scalp hair loss that had gradually worsened over several years. She was not currently on treatment. The patient also reported a history of vitamin D deficiency, mild iron deficiency, and thyroid disease, though none were severe.
Additionally, she presented with facial acne consisting of inflammatory papules, pustules, and comedonal papules.
Clinical Examination
Scalp findings: Diffuse hair thinning consistent with female pattern hair loss (androgenetic alopecia).
Hair pattern: Widened midline part with preservation of the frontal hairline.
Face: Active inflammatory acne lesions on cheeks and jawline.
General exam: Patient appeared well-developed, alert, and in no acute distress.
Diagnosis
Androgenetic Alopecia (Female Pattern Hair Loss)
Genetic, progressive condition.
Differentiated from telogen effluvium and scarring alopecia based on history and exam.
Inflammatory and Comedonal Acne
Chronic condition with risk of scarring if untreated.
Treatment Plan
Hair Loss Management
Minoxidil 5% topical foam recommended for daily use.
Extensive counseling on oral minoxidil provided, including risks such as dizziness, ankle swelling, unwanted hair growth, and low blood pressure.
Reviewed additional treatment options: spironolactone, finasteride/dutasteride, supplements (Nutrafol), low-level laser caps, PRP (platelet-rich plasma), and Alma TED therapy.
Patient expressed interest in considering Alma TED in the future.
Acne Management
Topical tretinoin 0.025% cream prescribed for nightly use.
Benzoyl peroxide wash and non-comedogenic moisturizers (such as Cerave PM, Cetaphil Oil Control, Elta MD UV Clear) recommended.
Counseling provided on:
Retinoid use (pea-sized amount, apply at night, dry skin before application).
Expectations – improvement typically takes 2–3 months with 60–80% reduction in acne.
Importance of consistent skincare routine.
Patient Counseling
The patient was advised that:
Female pattern hair loss is progressive, but early treatment can slow thinning and promote regrowth.
Acne is chronic but manageable with consistent treatment, and early control can reduce scarring risk.
Lifestyle factors (nutrition, stress, and hormone regulation) may also influence both conditions.
Conclusion
This case highlights the importance of a comprehensive approach to treating women with androgenetic alopecia and acne. Combining evidence-based treatments such as topical minoxidil and tretinoin with supportive skincare and advanced options like Alma TED or PRP allows for long-term improvement and better quality of life.
If you are struggling with hair loss or acne in Houston or Katy, Texas, our clinic offers advanced diagnostics and customized treatment plans tailored to your needs.
