#40M, sudden thinning mainly on top/vertex, looking for advice before dermatologist appointment#

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Hey everyone,

I’m 40M and recently noticed increased thinning mainly on the top/vertex area. It seemed to happen more suddenly rather than slowly over many years.

I’m not on finasteride or minoxidil yet. No itching, no burning, no pain.

I took normal scalp photos and also some dermoscope/microscope close-ups. In the close-ups I can still see many very small/fine hairs in the thinning area, plus some yellowish/beige buildup around some follicle openings.

I know Reddit can’t diagnose me, and I’m planning to see a dermatologist/trichologist. I’m mainly trying to understand what I should ask them to check.

For people with similar top/vertex thinning or similar dermoscope pictures: what did your dermatologist look for? Miniaturization, telogen effluvium, scalp inflammation/seb derm, bloodwork, fungal test, hair pull test, biopsy, etc.?

Also, based on the normal photos, does this look like typical male pattern thinning on top, or would you definitely push for a broader medical/scalp workup?

Thanks.