Tofacitinib 2% Ointment, a Topical Janus Kinase Inhibitor, for the Treatment of Alopecia Areata: A Pilot Study of 10 Patients

In a 24-week pilot study involving 10 patients with alopecia areata (AA), the application of tofacitinib 2% ointment, a topical Janus kinase inhibitor, twice daily resulted in hair regrowth in 3 out of 10 subjects. The mean decrease in Severity of Alopecia Tool (SALT) score among these responders was 34.6%, with one patient showing a 61% improvement. However, the study also noted adverse events such as scalp skin irritation in 40% of patients and folliculitis in 10%, both of which resolved without treatment. Additionally, 40% of patients experienced a minimal elevation in total cholesterol. The study concluded that while the level of response to topical tofacitinib was less than that seen with oral tofacitinib, it was similar to that reported with clobetasol 0.05% ointment under occlusion. Further research was deemed necessary to better understand the treatment of AA with topical JAK inhibitors.