Late hair fall on minoxidil?

Question

Hi! I am a 39 year old female with recurrent TE. Dermatologist ran prelim blood and was clear. Trialed Nutrafol with initial results and then recurrent TE. On month 10 of topical minoxidil and following initial hair fall was having excellent results. Starting 3 months ago began shedding new growth (3-5 inch hairs only). Dermatologist wants to do biopsy because she doesn’t know what else to do. I feel like we are missing something. Hair is most sparse along hairline and temples, but only to me.

Jeff Donovan, MD, PhD · Answer

Well, I would need to know way more about your story and see the scalp up close myself to say what is going on. But let me say that “recurrent TE” is women 39 with normal blood tests usually means androgenetic alopecia. not always of course - but yes - usually. See an expert. A biopsy can get you to the right diagnosis provided the sample is taken from the right area (and not some random area) and provided it is interpretted by an expert dermpath (and not someone who does not enjoy reporting pathology for hair). As far as recent shedding, you will need to consider also stress, past COVID and flu since January, other supplements, other meds, weight loss. I can’t get the information I need from these few paragraphs you write and need answers to 50 questions. But androgenetic alopecia is the key diagnosis that 100 % needs to be rules in or ruled out.

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