Dupilumab and Alopecia Areata: A Possible Combined or Disturbance Therapy? A Review of the Literature

A 27-year-old male with diffuse hair loss, including the donor area, did not respond to finasteride, dutasteride, or minoxidil. He suspects his hair loss may be linked to a mild connective tissue disorder, possibly affecting the structural support of hair follicles, rather than being purely hormonal.

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.

The user discusses their hair loss experience, exploring various hypotheses including thyroid levels, vitamin D, DHEA, nutritional deficiency, diabetes, seborrheic dermatitis, lack of nutrition to hair follicles, chronic inflammation, female pattern hair loss causes, cortisol, and prolactin levels. They are currently using finasteride, beta-sitosterol, and have tried topical dutasteride and microneedling therapy.

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.

High DHEA levels may contribute to hair loss by increasing DHT in hair follicles, potentially explaining why finasteride is ineffective for some. Treatments like high-dose dutasteride and RU58841 are suggested, but the underlying cause, such as adrenal issues, should be investigated.

A person with alopecia universalis is considering using Xeljanz but is advised that Olumiant is more effective for their condition. They are under a dermatologist's care and should expect gradual progress, as follicles dormant for 20 years are challenging to reactivate.