Efficacy of Oral Tofacitinib in Moderate to Severe Alopecia Areata, Totalis, and Universalis at the Tertiary Care Hospital, Karachi

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 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.

Baricitinib, approved for alopecia areata, might be considered for treating receding hairlines. The discussion is about the possibility of an over-the-counter topical version for androgenic alopecia.

An arthritis drug restored significant hair in people with alopecia areata, but it is not effective for male pattern baldness. The drug, Upadacitinib, has serious side effects and is expensive.