What is Alopecia Areata and How to Treat It

By Laura Monaghan, PA, MMS

Do you or a loved one suffer from patches of non-scarring hair loss? This type of hair loss, known as alopecia areata (AA), is considered a chronic autoimmune disorder. It affects about 300,000 people in the US annually. AA severity can range from one singular patch of hair loss to complete baldness. Patients may also suffer from loss of eyebrow, eyelash, facial, and body hair. Beyond physical implications, AA can also have a significant negative impact on mental health. Hair is often linked to self-identity, especially for women. Research supports the fact that AA causes psychologic distress, which can manifest as personal, social, and work-related problems.

Treatment Options for Alopecia Areata

There are multiple approaches to treating alopecia areata. A common and relatively simple treatment is the administration of intralesional steroid injections every 4-6 weeks. Other therapies include topical or oral steroids, topical minoxidil, anthralin, and topical immunotherapy with Diphenylcyclopropenone (DPCP), dinitrochlorobenzene (DNCB) or squaric acid dibutyl ester (SADBE). While some patients see hair regrowth with these treatments, others have been left feeling frustrated by lack of response.

JAK Inhibators for Hair Loss Treatment

In June of this year, the first oral medication gained FDA approval for treatment of alopecia areata, Baricitinib (Olumiant). Baricitinib is a JAK inhibitor, a class of medications traditionally used for treating rheumatoid arthritis and certain blood disorders. Patients with these rheumatologic conditions incidentally noticed hair regrowth, and subsequent clinical trials supported the efficacy of JAK inhibitors for treating AA.

The promise of JAK inhibitors, however, is not without some risk. Because JAK inhibitors target multiple cellular signaling pathways involved in the immune system, they can increase the risk of serious infection, heart attack, stroke, blood clots, cancer, and death. Yet data for these adverse effects is from patients with rheumatoid arthritis; it is unclear if these warnings apply equally to patients with AA. As long-term data is collected, we will gain a better understanding of the impact of JAK inhibitors on the AA population.

Given the demand for more effective AA treatment, two additional JAK inhibitors are expected to gain FDA approval in the near future. These exciting developments bring hope for patients suffering with alopecia areata.


Contact us to make an appointment for a hair loss consultation with a dermatologist. We can help diagnose the type of hair loss and find a treatment that’s best for you.