Oral Tofacitinib for Refractory Lichen Planus Pigmentosus Coexisting with Frontal Fibrosing Alopecia

A 23-year-old male is experiencing diffuse hair loss and miniaturization, possibly due to high IGE levels after using tofacitinib. He seeks advice and has not yet consulted a dermatologist.

Topical tretinoin applied to the face may exacerbate hair loss in some individuals, potentially triggering conditions like frontal fibrosing alopecia. Experiences vary, with some users reporting no impact on hair, while others experience significant hair loss.

The user is using oral finasteride, topical minoxidil, and tretinoin to treat hair loss. After two months, there is noticeable thickening and maintenance of the hairline.

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.

Topical pirfenidone is highlighted as an effective anti-inflammatory and anti-fibrotic treatment for hair loss, particularly in addressing perifollicular fibrosis, which may enhance the effectiveness of standard treatments like finasteride and minoxidil. The user also uses calcipotriol, MCT oil, ciclopirox shampoo, and benzoyl peroxide shampoo as part of their regimen.

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.