Exploring New Treatment Options for Androgenetic Alopecia in a 65-Year-Old Female in Katy & Houston, Texas

At Reena Jogi, MD, we frequently see patients with androgenetic alopecia (female pattern hair loss) who require ongoing adjustments to their treatment plan. This case highlights a 65-year-old female from the Katy and Houston, Texas area who presented for follow-up after previous therapies, including platelet-rich plasma (PRP) injections.

Patient Background

The patient was previously evaluated for diffuse hair thinning and patterned alopecia in January 2025. At that time, she began PRP injections in combination with oral medications.

Since then, she reported:

• Continued daily use of oral minoxidil and oral dutasteride

• Perception of worsening hair thinning despite adherence

• Decision to discontinue PRP injections at this time

She presented for re-evaluation and to explore additional therapies.

Clinical Findings

On examination:

• Patterned hair loss consistent with female pattern alopecia

• Diffuse non-scarring thinning across the scalp

• Preservation of the frontal hairline, typical in women with androgenetic alopecia

Diagnosis

Androgenetic Alopecia (Female Pattern Hair Loss) – progressive, chronic thinning influenced by genetics and age.

Treatment Plan

After counseling and reviewing treatment options, the patient elected to:

• Continue oral minoxidil 2.5 mg daily

• Consider alternative treatments, including:

  • Alma TED™ therapy – a non-invasive ultrasound-based treatment to promote follicle health

  • Topical minoxidil as an adjunct

  • Dutasteride scalp injections for localized follicle stimulation

• Patient will be scheduled for Alma TED while continuing her oral regimen

Counseling Provided

The patient was educated on:

• Long-term expectations: androgenetic alopecia is genetically pre-determined and slowly progressive

• Treatment outcomes: stabilization is often more achievable than complete reversal

• Medication counseling:

  • Oral minoxidil side effects include dizziness, unwanted hair growth, ankle swelling, and allergic reaction

  • Monitoring for side effects and reporting any worsening symptoms

Follow-Up Plan

The patient will return after initiating Alma TED to assess her response and determine whether additional therapies should be incorporated.

Why This Case Matters for Women in Katy & Houston

Female pattern hair loss is one of the most common causes of thinning hair in women over 60, yet it is often undertreated. Many patients benefit from a multimodal approach, combining oral medications, topical therapies, in-office procedures like PRP or Alma TED, and supportive supplements such as Nutrafol or Viviscal.

This case demonstrates the importance of ongoing follow-up and adjusting the treatment plan when initial therapies do not yield the desired improvement.

Key Takeaways:

• Female pattern hair loss is chronic, progressive, and genetically determined

• Combination therapy is often needed for best outcomes

• Alma TED offers a promising, non-invasive addition for patients not improving on traditional treatments

• Ongoing follow-up ensures treatment adjustments are made promptly