Treatment of Alopecia Universalis with Topical Janus Kinase Inhibitors – A Double Blind, Placebo, and Active Controlled Pilot Study

This phase I, 28-week, placebo-controlled, double-blind study investigated the efficacy of two topical JAK inhibitors, 2% tofacitinib and 1% ruxolitinib, in treating alopecia universalis in 16 patients. Partial hair regrowth was observed in 6 patients using 2% tofacitinib and in 5 patients using 1% ruxolitinib, compared to 10 patients using clobetasol dipropionate 0.05% ointment. No regrowth occurred in placebo-treated areas. Notably, two patients experienced generalized hair regrowth, with one achieving 100% regrowth by week 24 but relapsing after 12 weeks. These findings suggested that topical JAK inhibitors could be a potential new treatment for alopecia areata, offering an alternative to clobetasol dipropionate.