Successful Treatment of Resistant Alopecia Totalis With Tofacitinib

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.

An arthritis drug, baricitinib, is discussed as a potential treatment for autoimmune alopecia, not androgenetic alopecia. Ritlecitinib is also mentioned as a possible treatment for scarring alopecia.

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.

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.

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.