Weird Hair Loss Pattern – Worth a Biopsy?

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Honestly, I’m a bit disappointed with my results and after 3 years on dutasteride and 1.5 years on min + tret, I expected more. Can anyone spot something I’m missing?

I didn’t track my progress seriously until now, but I’ve started taking more consistent photos. The last two are from 2023 with my usual mid-length hair; the first one is from 2025 after buzzing it down.

That buzzed photo clearly shows a strange hair loss pattern I hadn’t noticed before. My scalp has been feeling raw lately, and about 3 weeks ago I added microneedling with the “Intelligent” pen at 0.5mm depth around the hairline, mid-scalp, and beard, skipping topicals on those days - 6 days on, 1 day off when I micro-needle.

I know the photos aren’t perfectly matched, but I really just care about picture 1. The last two are for some context to how my hair looked before. I’m trying to figure out if it’s worth paying for a scalp biopsy because I feel like this might be more than just DHT caused loss.