Congenital Alopecia Areata: A Systematic Review

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.

Androgenic alopecia (AGA) might have evolved to reduce prostate cancer risk by increasing UV exposure to the scalp, but this theory is debated. Treatments like minoxidil and finasteride are used for AGA, though the exact causes and evolutionary reasons for hair loss are unclear.

Dihydrotestosterone (DHT) impacts various skin conditions, including Androgenetic alopecia and seborrheic dermatitis, by causing overactivity in sebaceous glands. Topical medications Tacrolimus and Clobetasol can reduce these inflammatory conditions, and treatments like RU58841, Minoxidil, and Finasteride may also be beneficial.

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 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.

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.