Inflammatory Infiltrate Precedes Collapse of the Immune Privilege in Human Alopecia Areata

A user has been experiencing hair loss for 4 years, with treatments like minoxidil, finasteride, and various supplements proving ineffective. They were diagnosed with fibrosing alopecia in a pattern distribution, a condition that may require a combination of anti-inflammatory and hair growth treatments.

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 20-year-old male has been experiencing hair loss since age 15-16 and is using oral minoxidil, dutasteride, and ketoconazole shampoo, with previous use of oral finasteride and topical minoxidil. He has stabilized hair loss but seeks to rule out inflammatory or immune-related causes, considering a scalp biopsy, and is supplementing with vitamin D3, B12, and iron.

Scalp inflammation may contribute to hair thinning, with treatments like ketoconazole shampoo potentially helping by reducing inflammation. Some users report that DHT blockers and other treatments like finasteride, minoxidil, and RU58841 can alleviate symptoms associated with inflammation.

The user experienced hair loss since 2019 and tried finasteride, dutasteride, RU58841, and ketoconazole shampoo without success. A scalp biopsy showed scarring and inflammation from folliculitis, indicating chronic inflammation was affecting treatment effectiveness.

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.