Does Complement Have a Role in the Pathogenesis 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.

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.

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.

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.

A 25-year-old experiencing hair thinning all over the body and head, despite using minoxidil and having low vitamin D levels, is advised to seek a second opinion from a dermatologist specializing in hair loss. The likely diagnosis is diffuse alopecia areata, which may require treatment with a JAK inhibitor.