Pharmacotherapy of Alopecia Areata

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.

Dihydrotestosterone (DHT) impacts various skin conditions, including Androgenetic alopecia and seborrheic dermatitis, by causing overactivity in sebaceous glands. Topical medications Tacrolimus and Clobetasol can reduce these inflammatory conditions, and treatments like RU58841, Minoxidil, and Finasteride may also be beneficial.

A user noticed a sudden bald spot and others suggested it might be alopecia areata, often stress-induced, recommending seeing a dermatologist for steroid injections. Topical minoxidil was mentioned as a successful treatment by one user.

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.

The user has been managing hair loss for over 15 years, using treatments like Minoxidil, Finasteride, and corticosteroids, while experiencing side effects and recurrent Alopecia Areata. They seek advice on progression and potential underlying conditions, questioning if their hair loss is due to an autoimmune issue beyond typical patterns.

Corticosterone inhibits GAS6, affecting hair follicle stem-cell activity, with potential implications for stress-related hair loss. Ashwagandha and Vitamin K are suggested for reducing cortisol, but their effectiveness is debated.