Alopecia Areata: A Review of Diagnosis, Pathogenesis, and the Therapeutic Landscape

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 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.

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.

Hair loss may be influenced more by inflammation, microbiome imbalances, and gut health than DHT. Treatments discussed include minoxidil, finasteride, RU58841, fecal microbiota transplants, and JAK inhibitors.

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.

An arthritis drug, baricitinib, is discussed as a potential treatment for autoimmune alopecia, not androgenetic alopecia. Ritlecitinib is also mentioned as a possible treatment for scarring alopecia.