Case Report: Managing Chronic Male Hair Loss with Oral Minoxidil and Topical Finasteride in Houston
Hair loss in men is often a gradual, genetically driven process that can be emotionally distressing and medically complex. At Reena Jogi MD Dermatology in Houston and Katy, Texas, we specialize in diagnosing and treating male hair loss using evidence-based, personalized care. This case features a 26-year-old male with androgenetic alopecia and underlying telogen effluvium, successfully managed with a modern treatment regimen.
Chief Complaint: Progressive Diffuse Hair Thinning
A 26-year-old male presented with a two-year history of progressive, diffuse scalp hair loss, moderate in severity and gradual in onset. He had previously tried oral finasteride for five months but discontinued due to side effects, later transitioning to oral minoxidil (5 mg daily), which he had been taking for six months. Notably, he experienced a sudden and distressing shedding episode one month prior to presentation.
The patient also reported a paternal family history of hair loss, further supporting a diagnosis of androgenetic alopecia (AGA).
Clinical Findings and Diagnosis
Our thorough examination included dermatoscopic evaluation and a scalp-focused hair inspection. The exam revealed:
Diffuse, non-scarring patterned hair loss
Positive hair pull test, especially in the mid-frontal scalp
No signs of scarring or inflammatory alopecia
Based on the clinical features and history, the diagnosis was consistent with:
Androgenetic Alopecia (L64.8)
Telogen Effluvium (L65.0)
This dual diagnosis is common, especially in young males under stress or adjusting to systemic therapies.
Treatment Strategy: Dual Therapy with Oral Minoxidil and Topical Finasteride
We discussed several treatment options, including:
Topical Finasteride (applied 1–2x daily)
Alma TED ultrasound-based therapy
Low-level laser therapy, hair supplements, and eventual hair transplant
After reviewing side effects, efficacy expectations, and costs, the patient chose to:
Continue oral minoxidil (5 mg twice daily), which he tolerated well
Start topical finasteride, compounded in powder form
We also provided extensive counseling on signs of minoxidil side effects such as chest pain, dizziness, or fluid retention. The patient verbalized full understanding of his medication regimen and was advised to follow up in six months for progress evaluation.
Counseling Highlights
Expectations for Androgenetic Alopecia
Chronic and progressive condition influenced by genetic factors
Affects the vertex and frontotemporal regions
Best managed with long-term therapy and regular follow-up
Understanding Telogen Effluvium
Triggered by physical or emotional stress, illness, or medication changes
Typically resolves within months once triggers are addressed
Supportive therapies like minoxidil and scalp care can accelerate recovery
Conclusion: A Personalized, Modern Approach to Male Hair Loss
This case exemplifies the evolving standard of care for male pattern hair loss. By combining oral minoxidil and topical finasteride, our patient initiated a well-tolerated and evidence-based regimen tailored to his specific needs. With open dialogue, follow-up, and future consideration of PRP, we’re optimistic about long-term improvement.
If you're experiencing hair loss in Houston or Katy, schedule a consultation with Reena Jogi MD for a personalized plan rooted in medical dermatology and cosmetic excellence.
