Overcoming Hurdles: Side Effects with Old Drugs and Achieving Success with Novel Drug in Alopecia Areata

An 11-year-old girl with alopecia totalis experienced no scalp improvement and developed azathioprine-induced transaminitis after using topical minoxidil and azathioprine. Upon switching to tofacitinib, her scalp hair regrew, and transaminitis resolved. The case highlights that improper use of minoxidil can cause reversible hypertrichosis, emphasizing the need for proper application techniques and patient counseling. Tofacitinib showed a positive response in treating alopecia areata.