My brother has extreme diffuse thinning and I don't know what to do (pics inside)

Timii

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I ' ve never talked about my brother before but his hair loss is getting out of hand. He is 18 (!) and has amazingly aggressive diffuse thinning, I honestly had normal male pattern baldness at his age (so 3 years ago), losing on temples while the top of the head remained intact. I don't know what to do with him, I mean the fact that I have to post here speaks volume... He's been taking finasteride daily for 6 months but I haven't noticed any regrowth, on the other hand it probably arrested his loss. Honestly, I'm not even sure if it's standard male pattern baldness? Even though I know people on here don't wanna hear that but guy has a very very inactive lifestyle (I mean very inactive, he spends most of his time lying ) and we were arguing that the total lack of physical activity might be the actual culprit, maybe some input from you could be useful, in February we have an appointment with a dermatologist. What is the best course of action? Dermapen+minoxidil all over his head? Hair transplant and if so how?
Pics down below
 

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Timii

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Anyone?
 

jazz1

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See what the dermatologist says first, you can use the BIG3 for male pattern baldness.
 
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