Managing Androgenetic Alopecia in a 32-Year-Old Female: Dose Adjustment and Long-Term Hair Restoration Planning

Jul 15

At Village Dermatology, serving Katy and Houston, Texas, we often see patients seeking long-term solutions for progressive hair thinning. This case features a 32-year-old female patient returning for follow-up care after her initial diagnosis of androgenetic alopecia (AGA) affecting the mid-frontal scalp and left superior parietal scalp.

Patient Background

The patient was first evaluated on March 12, 2025, and started on oral minoxidil 2.5 mg, with a gradual dose escalation plan beginning at ¼ tablet daily, increasing to ½ tablet daily. At her follow-up visit, she reported no significant side effects and noted that her hair loss appeared stable.

Clinical Findings

A thorough scalp examination with dermatoscopy revealed diffuse non-scarring hair loss and patterned thinning consistent with AGA. No scalp inflammation or scarring was observed.

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Treatment Plan and Counseling

To further optimize results, the patient’s oral minoxidil dose was increased from ½ tablet to 1 full tablet daily. She was counseled on the potential side effects, including:

Chest pain
Ankle swelling
Fluid retention
Low blood pressure
Dizziness or lightheadedness
Unwanted hair growth

We also discussed additional hair restoration options, including:

Oral spironolactone – for its anti-androgen effects in women
ALMA TED – a non-invasive, in-office treatment designed to stimulate hair growth and improve scalp health

The patient elected to proceed with the higher minoxidil dose at this time and received an ALMA TED information handout for future consideration.

Education & Expectations

Patients with AGA are counseled that the condition is genetically pre-determined and slowly progressive. While treatments like minoxidil and spironolactone can help slow shedding and promote regrowth, results typically take 6 months or longer and require ongoing maintenance.

We also provided hair care guidance, recommending gentle shampooing, avoiding excessive heat styling, and ensuring proper scalp hydration.

Follow-Up

The patient will return in 6 months to evaluate treatment response and discuss whether to incorporate ALMA TED or other supportive therapies into her regimen.

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