Treatment Effects of Intradermal Botulinum Toxin Type A Injection on Alopecia Areata

A 35-year-old with alopecia areata has tried finasteride, topical and oral minoxidil, and dutasteride without success in stopping hair loss. The dermatologist suggests JAK inhibitors, but they are too costly, leading to uncertainty about the cause of hair loss.

Topical tacrolimus is being considered for androgenetic alopecia, though its effectiveness is unproven. Other treatments mentioned include minoxidil, dutasteride, cyclosporine, and teicoplanin, with discussions on blocking the prolactin receptor for hair growth.

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 using finasteride and oral minoxidil for two years without improvement in diffuse thinning and is considering switching to dutasteride and getting a scalp biopsy. Suggestions include treating subclinical hypothyroidism, trying PRP therapy, and checking for autoimmune issues.

The conversation is about a person experiencing treatment-resistant androgenic alopecia despite using high doses of dutasteride and minoxidil, along with other treatments like microneedling and purilutamide. Suggestions include considering a hair transplant, checking medication authenticity, and exploring other treatments like RU58841 or topical estradiol.