Managing Androgenetic Alopecia & Seborrheic Dermatitis in a Young Female with PCOS in Houston & Katy, TX
Introduction
At Reena Jogi MD, we specialize in diagnosing and treating various forms of hair loss in patients across Houston and Katy, Texas. This case study highlights a 23-year-old female with a long history of diffuse hair thinning linked to polycystic ovary syndrome (PCOS), along with seborrheic dermatitis. Her treatment plan incorporates both medical therapy and at-home devices to address her hair loss and scalp health.
Patient Background
The patient, a 23-year-old woman, reported progressive hair loss for the past nine years, beginning around the time of her PCOS diagnosis in 2016. She described her hair loss as diffuse, moderate in severity, and gradually worsening.
Examination & Findings
Hair Loss Type: Diffuse, non-scarring hair thinning consistent with androgenetic alopecia (AGA)
Hair Pull Test: Positive, indicating active shedding
Additional Scalp Condition: Seborrheic dermatitis presenting as pink/orange scaly plaques
Contributing Factor: Underlying hormonal imbalance related to PCOS
Diagnosis
Androgenetic Alopecia (Female Pattern Hair Loss) – Genetic and hormonal influences likely linked to PCOS.
Seborrheic Dermatitis – A chronic scalp condition that can contribute to hair shedding.
Treatment Plan
For Hair Loss (AGA)
Medication: Spironolactone 50 mg twice daily to address hormonal components of hair loss.
At-Home Device: Low-level laser therapy for scalp stimulation.
Future Consideration: Platelet-rich plasma (PRP) treatments for added hair regrowth potential.
Counseling Provided:
Discussed all treatment options including oral minoxidil, finasteride, topical minoxidil, supplements (Nutrafol, Viviscal, Votesse), and PRP therapy.
Explained possible spironolactone side effects such as breast tenderness, menstrual irregularities, dizziness, fatigue, and elevated potassium levels.
For Seborrheic Dermatitis
Prescription: Zoryve® 0.3% topical foam, applied once daily to the scalp.
Shampoo Regimen:
Ketoconazole 2% shampoo for anti-fungal control.
Alternating OTC anti-inflammatory shampoos with tar, selenium, or zinc pyrithione for maintenance.
Counseling Provided:
Educated the patient on flare triggers (stress, weather changes).
Advised consistent scalp care to reduce inflammation and flaking.
Outcome & Follow-Up
The patient will continue her medication and scalp care regimen with plans to reassess in one year. If shedding persists, PRP treatments may be initiated sooner.
Why This Case Matters:
This case underscores the importance of a tailored approach for young women with PCOS-related hair loss. Addressing both hormonal influences and scalp health can significantly improve long-term hair preservation and regrowth.
