Post-Cancer Hair Loss and Androgenetic Alopecia in a 40-Year-Old Woman: A Personalized Treatment Journey in Houston and Katy, Texas
Hair loss can be a particularly sensitive issue for women, especially following life-changing health events like breast cancer. At Reena Jogi MD Dermatology, we understand how important hair restoration is to a patient's self-image and emotional recovery. In this case report, we review the personalized treatment strategy for a 40-year-old woman from the Houston and Katy, Texas area, dealing with persistent scalp hair loss and eyelash thinning after cancer treatment.
Patient Background
The patient, a healthy and active 40-year-old female, presented with moderate, focal hair loss that began one year ago during treatment for breast cancer. She had completed radiation therapy in December 2024 and was nearly a year post-chemotherapy. Previous attempts at managing her hair loss—including topical minoxidil/finasteride and spironolactone 25 mg—were minimally effective.
Clinical Evaluation
During her consultation, a dermatoscopic scalp exam revealed signs consistent with androgenetic alopecia (AGA)—a genetically driven condition of progressive hair thinning that is often exacerbated by hormonal shifts, such as those experienced during cancer treatments. A positive hair pull test further supported this diagnosis.
She also reported thinning of the eyelashes, a condition known as eyelid hypotrichosis, which can accompany AGA or result from chemotherapy.
Customized Treatment Plan
Given her history of breast cancer, special precautions were taken. Oral finasteride and dutasteride were avoided due to their hormonal mechanisms and possible risks for hormone-sensitive cancer survivors.
After discussing risks, benefits, and realistic expectations, the following non-hormonal and evidence-based plan was recommended:
✅ Scalp Hair Loss Treatment:
Oral Minoxidil 2.5 mg daily – Initiated to support hair regrowth with systemic stimulation
Spironolactone 50 mg twice daily – Increased dosage for enhanced anti-androgenic effect
CMP lab panel ordered prior to starting to monitor potassium and kidney function
Will reassess in 1 month with lab follow-up and in 3 months for clinical progress
✅ Eyelash Thinning (Eyelid Hypotrichosis):
Latisse (Bimatoprost 0.03%) applied nightly to the upper eyelid lash line to encourage regrowth
Patient Education and Follow-Up
The patient was thoroughly counseled on the expected timeline for hair regrowth, potential side effects (such as temporary shedding, lightheadedness, and swelling), and the importance of consistent use. She was advised that visible improvement may take 3–6 months and that maintenance therapy is essential to prevent regression.
Because the patient currently wears a mesh hair piece, she was advised that future cosmetic procedures like PRP or Alma TED would require its removal. Her hairstylist will provide progress photos after removal to monitor improvement.
Conclusion
This case highlights the need for personalized, evidence-based care for women recovering from cancer-related hair loss. By tailoring treatment around safety, efficacy, and the patient’s comfort level, we provide compassionate, expert care at our Houston and Katy dermatology clinics.
If you or someone you love is experiencing hair loss after cancer or hormonal changes, the team at Reena Jogi MD Dermatology is here to help you reclaim confidence in your appearance. Call Honey C. now at 713-487-4061 to get started!
