What happens if I stop using Baricitinib? Does all the progress disappear?

Baricitinib, a medication originally developed to treat rheumatoid arthritis, has gained attention in recent years for its effectiveness in treating alopecia areata, an autoimmune disease that causes sudden hair loss. Many people who have seen positive results with this treatment ask a very important question: What happens if I stop using it? Will all the progress be lost?

This question is entirely valid, especially considering the emotional and financial investment required to follow a long-term pharmaceutical treatment. In this article, we address that concern using available scientific evidence.

How long-lasting is the progress with Baricitinib compared to other treatments?

Unlike treatments such as minoxidil —widely used for androgenetic alopecia— whose effects are usually seen after 4 to 6 months of continuous use, Baricitinib has shown visible results in relatively shorter periods. In the BRAVE-AA1 study, about 35% of participants taking a daily dose of 4 mg of Baricitinib showed significant improvement (over 80% scalp coverage) in just 36 weeks (

It’s important to note that, like minoxidil, progress with Baricitinib is not immediate and does not guarantee full hair regrowth in all cases.

Response varies depending on the severity of alopecia areata, the duration of the condition, and individual immune system factors. In terms of treatment projection, most specialists recommend continuing Baricitinib for at least 6 to 12 months before fully evaluating its effectiveness. Early discontinuation may limit the potential for hair regrowth, as Baricitinib works by modulating an inflammatory pathway (JAK-STAT) responsible for the autoimmune attack on hair follicles. As long as this pathway remains active and untreated, the autoimmune process is likely to continue.

Relapse: A common scenario after stopping Baricitinib

Most studies to date indicate that there is a high risk of relapse after discontinuing Baricitinib. This means many people experience renewed hair loss once the treatment stops.

A randomized controlled clinical trial published in The New England Journal of Medicine in 2022 (King et al., 2022) evaluated the efficacy and safety of Baricitinib in patients with severe alopecia areata. In that study, participants who discontinued the drug after 36 weeks showed progressive hair loss in the weeks that followed. In other words, the progress was not sustained without ongoing treatment. Baricitinib works by blocking a cell-signaling pathway known as JAK-STAT, which is involved in the autoimmune inflammation that attacks hair follicles. When the medication is stopped, this signaling is reactivated, and the immune system resumes its attack on the follicles, leading to renewed hair loss.

Is it possible to maintain results without Baricitinib?

So far, there is no strong evidence showing that the results achieved with Baricitinib can be maintained permanently after discontinuation. In fact, a subanalysis of the BRAVE-AA1 and BRAVE-AA2 trials, conducted by Lilly (the pharmaceutical company that developed Baricitinib), noted that more than 80% of patients who stopped treatment after achieving 80% scalp coverage lost part or all of their regrowth within the following six months. Some researchers have suggested that after achieving significant improvement, it may be possible to attempt a gradual dose reduction to test whether the body can maintain results without the drug. However, this approach is not yet supported by long-term studies with large sample sizes.

What are the risks of abruptly stopping an immunomodulator like Baricitinib?

While Baricitinib does not cause a “withdrawal syndrome” like some psychiatric medications or corticosteroids, it is important to understand that it is a powerful immunomodulator. Abrupt discontinuation can trigger a rebound effect—a rapid reactivation of the immune system that may accelerate hair loss relapse. Additionally, in people who also have inflammatory conditions such as rheumatoid arthritis, stopping the medication can worsen joint symptoms or lead to systemic flare-ups. This is why specialists emphasize that any dosage change should be done under medical supervision. Baricitinib is not an over-the-counter drug. It must be prescribed by a healthcare professional and requires a prescription in most countries due to its potential side effects and its impact on the immune system.

Discontinuing Baricitinib without a follow-up strategy often results in losing the regrown hair. While there are no severe side effects from stopping the treatment itself, relapse is, according to current evidence, highly likely.

This is because the medication does not “cure” alopecia areata; it controls the disease as long as it is being used.

Moreover, since it is an immunomodulator originally approved for another condition (rheumatoid arthritis), its prescription and supervision should be handled by a physician experienced in alopecia—preferably a dermatologist. This includes selecting the correct dose and planning for any potential discontinuation.

For this reason, if you're considering stopping the treatment, it's best to speak with your dermatologist to explore future options, assess your specific clinical case, and discuss possible maintenance therapies. Science is still investigating how to sustain benefits long-term without indefinite reliance on immunomodulatory drugs.

User Experiences

Community feedback on stopping Baricitinib consistently reflects a shared concern about the loss of progress after discontinuation. In one of the most detailed and directly relevant threads, users discussed the temporary nature of results with Baricitinib, particularly in the context of treating alopecia areata, an autoimmune condition. One individual expressed frustration after learning that hair regrowth from JAK inhibitors like Baricitinib is often lost once treatment ends. Other users confirmed this, stating that relapse is common unless the drug is continued, with regrown hair often shedding within weeks to months after cessation.

Several users noted that while Baricitinib is effective for initiating hair regrowth in many patients, it acts more as a disease suppressor than a cure. As one user put it, "the moment you stop, the immune system goes back to attacking the follicles." Another commenter, identifying themselves as a dermatologist, reiterated that long-term use may be necessary and warned of the high recurrence rate when patients stop taking the medication. There were also reports of users switching to other JAK inhibitors or combining therapies (like corticosteroids) to attempt to sustain regrowth, but the sentiment remained cautious. Users mentioned the cost and potential side effects—like changes in lipid levels and risk of infections—as key reasons why continuous treatment is difficult or undesirable. In summary, the community consensus is that stopping Baricitinib leads to a high likelihood of losing all or most of the hair regrowth it induced. It's viewed as a maintenance therapy rather than a permanent fix, requiring ongoing administration to preserve results.

references

King, B., Guttman-Yassky, E., Peeva, E., Banerjee, A., Sinclair, R., Pavel, A. B., Zhang, W., & Craiglow, B. (2022). Two phase 3 trials of baricitinib for alopecia areata. New England Journal of Medicine, 386(18), 1687–1699. https://doi.org/10.1056/NEJMoa2110343

U.S. Food and Drug Administration. (2022). Olumiant (baricitinib) label. https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/207924Orig1s011lbl.pdf

Liu, L. Y., Zeng, J., Zhang, Y., Zhang, J., & Yu, C. (2023). Long-term efficacy and safety of Janus kinase inhibitors in alopecia areata: A systematic review. Journal of Dermatological Treatment, 34(2), 1–9. https://pubmed.ncbi.nlm.nih.gov/36402134/

Reddit user. (2023, June 28). Anyone heard of or have experience using baricitinib? r/tressless. https://reddit.com/r/tressless/comments/14kv4wk/anyone_heard_of_or_have_experience_using/baricitinib

Reddit user. (2023, February 9). What are the odds baricitinib will get a topical otc version for androgenic alopecia? r/tressless. https://reddit.com/r/tressless/comments/10y9lxi/what_are_the_odds_baricitinib_will_get_a_topical/

Reddit user. (2022, September 3). I am a dermatologist with a clinical interest in alopecia. AMA. r/tressless. https://reddit.com/r/tressless/comments/x4jltq/i_am_a_dermatologist_with_a_clinical_interest_in/

Reddit user. (2024, October 5). What else is good. Besides the big 3. r/tressless. https://reddit.com/r/tressless/comments/1fwfoxu/what_else_is_good_besides_the_big_3/

For more community discussions and research, search "Baricitinib" at https://tressless.com/search/Baricitinib.