Systemic Treatments for Alopecia Areata: A Systematic Review

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 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.

Hair loss treatments include finasteride, minoxidil, microneedling, dutasteride, CB-03-01, RU-58841, and experimental options like KY-19382 and stem cell therapy. Some treatments are considered ineffective or risky, such as ketoconazole, PRP, and low-level laser therapy.

The review discusses traditional hair loss treatments like minoxidil and finasteride, and newer options like Low-Level Laser Therapy, microneedling, and platelet-rich plasma for androgenetic alopecia. It highlights the need for more high-quality trials to assess these treatments' effectiveness and standardized protocols for emerging therapies.

Minoxidil and finasteride are the only FDA-approved treatments for androgenetic alopecia, while newer treatments like clascoterone, PP405, NV-623/624, AMP-303, and RU58841 are still experimental with varying levels of evidence. Clascoterone shows the most promise due to strong human data, while AMP-303 has notable early human trial results; RU58841 lacks human data and remains experimental.

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.