Thinning hair and increased facial hair

Patient: I’m a 30 year old female. For the past three years I’ve noticed the hair on my head has thinned dramatically. I’ve been measuring the circumference of my ponytail since I was 20 because I belong to a hair care and growth community. My hair had consistently been 3.5 inches in circumference for years. Now it’s under 2 inches. I’ve also noticed a huge increase in coarse dark hair growing on my chin and my eczema has been getting worse.I’ve had bad acne since puberty, but lately it seems that the acne on my shoulders and back has been getting worse.But my menstrual cycle has remained as regular as clockwork.I will be going to a doctor soon to discuss these issues, but are there any specific tests I should ask to have done? And is it possible for me to regain the thickness of my hair?Thank you for any help or suggestions you can provide!

Symptoms: Head hair loss, facial hair increase, increased eczema, increased acne on shoulders, brittle fingernails

Doctor: Hello,I understand that you are suffering from gradual thinning of your scalp hair, increase in facial hair and acne.I would consider the diagnosis of female pattern hair loss in you. Coupled with your other issues, I would like to rule out underlying hormonal disorders like Polycystic ovarian disease.(PCOD)The investigations I would suggest to you before starting any treatment includeserum FSH ( follicular stimulating hormone)serum LH ( leutinizing hormone)serum Prolactin levelsserum free testosterone levelsserum cortisol levels.pelvic ultrasoundFor hair loss alone, you could also get a serum ferritin and hemoglobin levels done. A TSH (thyroid stimulating hormone) level would also be important.PCOD could occur even in the presence of a normal menstrual cycle.Minoxidil is an US-FDA approved drug for the management of female pattern hair loss. It will help to preserve the existing hair as well as slowly reagin the volume.Laser hair reduction is a very good option for coarse facial hairs. This is best started after ruling out underlying hormonal issues.For acne, you could use a gel containing clindamycin phosphate in the morning and a gel containing 2.5% benzoyl peroxide at bedtime.Hope this helps you.Take care.