Early-Onset Androgenetic Alopecia in a 17-Year-Old Male with Scalp Seborrheic Dermatitis
Hair loss at a young age can be both distressing and confusing. At Reena Jogi MD Dermatology in Houston and Katy, we provide compassionate and evidence-based treatment plans for teenagers and young adults facing hair thinning, often due to genetic conditions like androgenetic alopecia (AGA).
This case involves a 17-year-old male with a one-year history of gradual scalp thinning, compounded by symptoms of scalp irritation consistent with seborrheic dermatitis.
Chief Complaint: Scalp Hair Thinning and Itching
The patient presented with:
Moderate, diffuse scalp hair loss, particularly on the vertex
History of scalp bumps and itching, which had recently improved
A family history of AGA on the paternal side (father and grandfather)
He had not tried any treatment prior to this visit and reported washing his hair three times a week. No prior lab work was performed.
Diagnosis and Findings
On dermoscopic scalp examination, we observed:
Diffuse, non-scarring thinning of the scalp
Positive hair pull test, indicating active shedding
Presence of pink-orange scaly plaques, consistent with seborrheic dermatitis
We diagnosed:
Androgenetic Alopecia (L64.8) – male pattern hair loss
Seborrheic Dermatitis (L21.8) – chronic, inflammatory scalp condition
Treatment Plan
✅ 1. Oral Minoxidil (2.5 mg daily)
The patient elected to begin treatment with low-dose oral minoxidil, a safe and effective option in adolescents under careful supervision. We reviewed:
Potential side effects: swelling, dizziness, unwanted hair growth
Monitoring needs: follow-up in 6 months
✅ 2. Topical Ketoconazole and Fluocinonide
For seborrheic dermatitis control:
Ketoconazole 2% shampoo – 3x per week
Fluocinonide topical solution – during active flares, limited to 2 weeks/month
Recommended alternating with over-the-counter anti-inflammatory shampoos
We counseled on avoiding long-term topical steroid use in sensitive areas due to risk of skin thinning, hypopigmentation, and telangiectasias.
✅ 3. Future Options: PRP & AlmaTED
After discussing long-term treatment strategies, the patient expressed interest in Platelet-Rich Plasma (PRP) therapy and AlmaTED ultrasound therapy as potential future options for enhanced regrowth and maintenance.
Patient Education and Counseling
We emphasized the nature of AGA as a progressive genetic condition, which can begin in adolescence. Treatment works best when started early. Counseling covered:
Minoxidil (topical and oral)
Finasteride (for future consideration)
Laser therapy caps
Supplements like Nutrafol, Viviscal, Votesse
Patient and guardian were provided clear expectations and handouts for AGA, PRP, and seborrheic dermatitis.
Conclusion: Managing Teen Hair Loss with a Personalized Approach
This case highlights the importance of early diagnosis and intervention for teenage patients with genetic hair loss. When combined with management of scalp inflammation, results can be significant. At Reena Jogi MD Dermatology, we are proud to offer multimodal, compassionate care to young men dealing with early hair thinning.
