Oral Minoxidil for Male Pattern Hair Loss
Patient Presentation
A 50-year-old male presented as a new patient to Reena Jogi, MD for evaluation of progressive hair loss on the scalp. He described generalized hair thinning that was moderate in severity, gradual in onset, and present for approximately three years. The patient also reported intermittent scalp itching.
Prior to presentation, he had been using Nutrafol supplements intermittently, with limited improvement. He sought a comprehensive evaluation and discussion of medical and procedural treatment options for hair restoration.
Clinical Examination
A thorough dermatologic examination was performed, including detailed scalp and hair inspection using dermoscopy, as well as examination of the head and face. The patient appeared well developed, well nourished, and in no acute distress.
Scalp examination revealed diffuse non-scarring hair loss with a patterned distribution, most prominent at the vertex and frontal scalp, consistent with androgenetic alopecia. A positive hair pull test indicated active shedding. A medical assistant was present during the examination as a chaperone.
Diagnosis
Based on clinical findings, the patient was diagnosed with:
Diffuse Non-Scarring Hair Loss of the Scalp
Given the degree of shedding and chronicity, a scalp punch biopsy was discussed as a diagnostic option to further confirm the diagnosis and rule out other causes of hair loss.
Treatment Discussion and Plan
An in-depth discussion was held regarding treatment options for male pattern hair loss, including:
Oral minoxidil
Finasteride
Topical minoxidil (Rogaine®)
Low-level laser therapy
Supplements
Hair transplant surgery
The patient was counseled that PRP and AlmaTED are cosmetic treatments and not covered by insurance. Risks, benefits, and expectations of each option were reviewed in detail.
After extensive discussion, the patient elected to proceed with oral minoxidil therapy and expressed interest in PRP and/or AlmaTED treatments in the future.
Oral Minoxidil Counseling
The patient was prescribed oral minoxidil 2.5 mg once daily, with instructions to discuss initiation with his cardiologist prior to starting therapy.
Counseling included:
It is common to experience temporary increased shedding during the first 8–10 weeks
Potential side effects reviewed in detail, including:
Shortness of breath
Ankle or leg swelling
Fluid retention
Dizziness or lightheadedness
Low blood pressure
Fast heart rate
Unwanted hair growth
Allergic reactions
The patient verbalized understanding of proper use and potential adverse effects. He was instructed to discontinue the medication and contact the office if concerning symptoms develop.
Counseling and Expectations
The patient was counseled that:
Androgenetic alopecia is genetically determined and slowly progressive
Combination therapy often provides the best long-term results
Early medical treatment can help slow progression and preserve existing hair
Procedural options such as PRP and AlmaTED can be effective adjuncts to medication
A follow-up visit was scheduled in 6 months to assess response to treatment and revisit procedural options.
Expert Male Hair Loss Care in Katy & Houston, TX
At Reena Jogi, MD, we specialize in the diagnosis and treatment of male hair loss, offering both medical therapies and advanced non-surgical hair restoration options. Each treatment plan is personalized based on the patient’s goals, medical history, and pattern of hair loss.
If you are experiencing progressive hair thinning and are looking for a hair loss specialist in Katy or Houston, Texas, our team is here to help.
