Early-Onset Androgenetic Alopecia in a 25-Year-Old Man: A Case Report from Katy & Houston, Texas
Hair loss in young men is common and often genetically driven. Early evaluation allows for timely intervention to slow progression and preserve hair density. At Reena Jogi, MD, we specialize in diagnosing and treating male pattern hair loss (androgenetic alopecia) using personalized, evidence-based treatment plans. This case highlights a 25-year-old male with long-standing hair thinning who elected to begin finasteride therapy.
Patient Presentation
A 25-year-old male presented as a new patient with a several-year history of gradual, generalized hair loss involving the scalp. The hair loss was described as moderate in severity and slowly progressive.
He denied scalp pain, itching, burning, or scaling and reported no prior medical hair loss treatments, aside from over-the-counter shampoos. The patient noted a positive family history of hair loss in his mother, suggesting a genetic predisposition.
Clinical Examination
A comprehensive dermatologic examination was performed, including evaluation of the scalp, hair, face, eyelids, lips, and nose. The patient appeared well developed, well nourished, alert, oriented, and in no acute distress.
Scalp examination demonstrated diffuse, non-scarring hair thinning with a patterned distribution, most prominent over the vertex and frontal scalp. A hair pull test was positive, supporting active shedding.
Diagnosis: Androgenetic Alopecia
Based on clinical findings and history, the patient was diagnosed with androgenetic alopecia. The diagnosis and natural course of male pattern hair loss were reviewed, including its genetically predetermined and slowly progressive nature.
A punch biopsy was discussed as an option to further confirm the diagnosis, though the clinical picture was strongly consistent with AGA.
Treatment Discussion & Shared Decision-Making
A detailed discussion was held regarding available treatment options, including:
Finasteride
Oral minoxidil
Low-level laser therapy
Hair growth supplements (Viviscal, Nutrafol, Votesse)
Hair transplantation
Procedural treatments such as PRP and AlmaTED were reviewed, including expectations, risks, and the fact that these therapies are cosmetic and not covered by insurance.
After extensive counseling, the patient elected to proceed with finasteride therapy.
Medication Plan & Counseling
Finasteride
Finasteride 1 mg tablet
Take one tablet by mouth once daily
Comprehensive counseling was provided regarding potential side effects, including:
Decreased libido
Decreased ejaculate volume
Gynecomastia
Mood changes or depression
The patient was reassured that these side effects are uncommon, and many men tolerate finasteride well with long-term benefit. Women were advised not to handle the medication.
All questions and concerns were addressed, and educational handouts were provided.
Expectations & Follow-Up
The patient was counseled that the goal of treatment is to slow or halt progression of hair loss, with regrowth possible in some areas. Improvement is typically assessed over 3–6 months of consistent therapy.
A follow-up visit in six months was scheduled to evaluate treatment response and provide medication refills.
Expert Male Hair Loss Care in Katy & Houston, Texas
At Reena Jogi, MD, we provide comprehensive care for men with hair loss, including early intervention for androgenetic alopecia and advanced treatment options when needed.
📍 Serving patients in Katy, TX and Houston, TX
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