Treatment Outcomes and Considerations for Topical Immunotherapy in Patients with Alopecia Totalis and Alopecia Universalis

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.

In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.

The conversation discusses using scalp antiandrogens like RU58841, pyrilutamide, or fluridil on the face to reduce sebum production, noting that clascoterone (winlevi) is an approved facial antiandrogen with underwhelming reviews.

Onion juice, when applied topically, is an effective treatment for Alopecia Areata, showing significant hair regrowth in both males and females. The study suggests it could be interesting to test its effectiveness on Androgenic Alopecia.

Hair loss treatments discussed include Minoxidil, Finasteride, RU58841, Alfatradiol, and Eucapil. Topical treatments must penetrate skin and may go systemic, with effectiveness varying.

Dihydrotestosterone (DHT) impacts various skin conditions, including Androgenetic alopecia and seborrheic dermatitis, by causing overactivity in sebaceous glands. Topical medications Tacrolimus and Clobetasol can reduce these inflammatory conditions, and treatments like RU58841, Minoxidil, and Finasteride may also be beneficial.