Possible Involvement of Skin Resident Memory T Cells in Refractory Alopecia Areata

PP405 is a promising experimental topical treatment for alopecia that reactivates dormant hair follicles by targeting cellular energy, with large-scale trials planned for 2026. While it shows potential, it cannot regenerate permanently destroyed follicles, making hair transplants the only guaranteed solution for advanced baldness currently.

A user with alopecia totalis, borderline universalis, seeks advice on getting into a Xeljanz trial or appealing insurance for coverage. They experienced significant hair regrowth but are now seeing hair loss again and want to try Xeljanz.

The user has been managing hair loss for over 15 years, using treatments like Minoxidil, Finasteride, and corticosteroids, while experiencing side effects and recurrent Alopecia Areata. They seek advice on progression and potential underlying conditions, questioning if their hair loss is due to an autoimmune issue beyond typical patterns.

A 27-year-old male with AGA and diffused thinning has been using oral Minoxidil, Finasteride, Vitamin D, B12, Iron, and Ketoconazole shampoo. Despite a hair transplant and improved blood levels, he continues to experience hair loss and suspects a possible misdiagnosis of Alopecia Areata Incognita.

Hair transplant recipients are concerned about whether dormant follicles are permanently damaged by incisions, but some believe undamaged follicles could still regrow if a treatment like PP405 is effective. Opinions vary on the impact of transplants on original follicles, with some suggesting treatments like finasteride can help regrow hair.

The user is experiencing diffuse thinning and inflammation despite using 2.5mg dutasteride daily, ciclopirox, and ketoconazole shampoos. They are considering treatments like hydroxychloroquine and JAK inhibitors due to suspected scarring alopecia and have faced challenges in obtaining a scalp biopsy.