Battling a receding tide: treatment for androgenic alopecia

A taxation lawyer, aged 36 years, presented with concerns related to a nine-month history of gradual onset male pattern hair loss, with bitemporal ‘M’-shaped recession and thinning over the crown. History and examination revealed no associated scarring, itching, redness or scaling. The patient had no recent illness, surgery or major stress. There were no symptoms of thyroid disease and no family history of autoimmune conditions such as thyroid disease or alopecia areata. Review of his mental health history revealed well-controlled generalised anxiety disorder managed with 100 mg of sertraline, which was commenced in 2015. There was no associated trichotillomania. Review of family history revealed male pattern hair loss in both grandparents beginning in middle age.