Hair Loss in a 20-Year-Old Male: Managing Androgenetic Alopecia and Chronic Telogen Effluvium in Houston & Katy, TX
Location: Reena Jogi MD – Hair Loss Specialist in Katy and Houston, Texas
A 20-year-old male recently visited our dermatology clinic in Katy and Houston, TX with a long-standing history of scalp hair thinning. Accompanied by his mother, the patient described his hair loss as moderate in severity and gradual in onset, persisting over the past few years. Despite being on oral finasteride (5 mg) and oral minoxidil (10 mg daily) for the past year, he noted no significant regrowth—only that his hair loss had stabilized.
Medical History and Evaluation
He reported a strong family history of male pattern hair loss, and his scalp exam supported the diagnosis of androgenetic alopecia (AGA). Additionally, a positive hair pull test indicated the presence of chronic telogen effluvium (TE)—a condition characterized by diffuse hair shedding often triggered by stress, illness, or nutritional deficiency.
Using dermatoscopy, Dr. Reena Jogi identified findings consistent with diffuse, non-scarring patterned hair loss, particularly on the mid-parietal scalp.
Diagnoses:
Androgenetic Alopecia (AGA)
Personalized Treatment Plan
After a thorough discussion of his condition, treatment options, and expectations, the patient decided to move forward with:
Starting Dutasteride 0.5 mg daily
A more potent 5-alpha reductase inhibitor than finasteride, dutasteride was added to help reduce further miniaturization of hair follicles.Continuing Oral Minoxidil 10 mg daily
A vasodilator that helps extend the anagen (growth) phase of the hair cycle.Scheduling AlmaTED Treatments
This non-invasive ultrasound-based therapy helps improve scalp health and stimulate hair regrowth without needles or downtime. Ideal for younger patients with AGA and TE who want to avoid injections.
Key Counseling Points Covered
Dr. Jogi provided in-depth counseling on the expected progression of AGA, the risks and side effects of both oral minoxidil and dutasteride, and the cosmetic nature of AlmaTED (not covered by insurance).
Patients were advised that:
AGA is progressive and genetic, typically affecting the vertex and frontal scalp.
Telogen Effluvium is self-limiting, often triggered by stress, nutritional deficiency, or thyroid imbalances.
AlmaTED and medical therapies are most effective when started early.
Patient Outlook
This motivated young patient is now on a multimodal therapy plan combining medical treatment with non-invasive scalp stimulation, which offers promising results for both hair preservation and potential regrowth.
Follow-up care was scheduled as needed, with plans to monitor response to AlmaTED and medication adjustments.
