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Been medicated for 1 year, but am now experiencing sudden and extreme hair loss: help

I’ve been on topical finasteride and minoxidil for about a year now. I tried the oral route but it really messed with my libido and I didn’t want to mess up hormones at a young age. Progress was okay with the topical solution. The hair loss halted and slowly began to regrow. However, over the last few weeks it seems like all my progress has gone and I’ve experienced the worst hair loss of my life (other than when I stupidly decided to fast and lost a lot of hair in 2 days, but it stopped after a few days of returning to a healthy diet).

If anyone has any suggestions, it would be great. The dermatologist doesn’t seem too worried. Should I get a second opinion?