Alopecia Treatments: Approved Medications and Clinical Trials Underway

In 2017, about 100 people affected by alopecia areata (“alopecia”) shared their personal experiences with an FDA expert panel. Many people voiced their frustrations about the current treatment options for alopecia. Understandably, too. As a health condition that causes hair loss, there are many emotional and physical challenges of living with alopecia. 

As time has progressed, alopecia advocates like these are starting to be rewarded for their efforts. In June 2022, the FDA approved the first oral medication for alopecia. Another one followed suit in June 2023. And more alopecia treatment options may be on the way, especially since the FDA cleared the path for a few treatments to get to market faster through its breakthrough therapy designation.

Here, we’ll cover the latest medications being researched for alopecia and how they stack up to current treatments.

What is alopecia areata?

Alopecia is a form of hair loss. It’s thought to be a type of autoimmune disorder, but environmental factors can also play a role.

Hair loss usually starts out patchy, with circular areas of hairlessness. It can happen anywhere on your body that grows hair (including eyebrows and eyelashes), but it usually starts at the scalp.

Many people regrow their hair, but others do not. There is also a wide range of possible hair loss symptoms, and some people may eventually lose all the hair on their body (called alopecia universalis).

What are the current treatments for alopecia areata?

There’s currently no cure for alopecia. But people living with alopecia still have several treatment options to consider trying.

Olumiant

Olumiant (baricitinib) is an oral tablet that’s taken once daily. It’s a Janus kinase (JAK) inhibitor that helps calm inflammation. It was originally approved to treat rheumatoid arthritis back in 2018, but it’s gained a couple more uses since then.

Olumiant was approved to treat certain hospitalized adults with COVID-19 in May 2022. Then, in June 2022, the FDA approved it to treat adults with severe alopecia. Olumiant was the first oral treatment option to be fully approved for alopecia.

Olumiant’s approval for alopecia is discussed in another GoodRx Health article.

Litfulo

Litfulo (ritlecitinib) is a once-daily oral capsule. Another JAK inhibitor, it’s FDA approved to treat severe alopecia in adults and kids ages 12 years and older. Litfulo is the first oral medication for adolescents with severe alopecia.

Litfulo and Olumiant work in a similar way. And they both promote scalp hair growth after several months of use. If age isn’t a factor, the best choice between the two may depend on your preferences, what’s available in your area, and cost.

Off-label treatments

Olumiant and Litfulo aside, many medications are used off-label to treat alopecia. Since alopecia happens when your immune system starts to attack your hair follicles, many of these medications work by calming it down. This gives your hair a chance to grow back. The best treatments depend on your age, the affected location(s) on your body, and the severity of your symptoms.

Off-label treatments for mild alopecia include:

• Topical minoxidil (Rogaine)

• Oral minoxidil

• Anthralin 

• Topical corticosteroids such as clobetasol

• Injectable (intralesional) corticosteroids such as triamcinolone

Off-label treatments for moderate to severe alopecia include:

• Oral minoxidil

• Oral corticosteroids such as prednisolone

• Topical or contact immunotherapy

• Methotrexate

• Dupixent (dupilumab)

• Xeljanz (tofacitinib) or another JAK inhibitor

Alternative therapies are another option. They have less supporting data, but some people find them to be helpful. If you’re looking for another option, consider asking your healthcare provider about:

• Acupuncture

• Topical melatonin

• Aromatherapy with essential oils

• Garlic extract

• Onion juice

Which companies are working on developing treatments for alopecia areata?

Researchers have been working hard to find new and improved treatment options for people living with alopecia. Over 100 clinical trials are studying the effects of different medications and other therapies.

One medication class of particular interest are JAK inhibitors. JAK inhibitors target a specific inflammatory pathway to promote hair growth in people with alopecia.

Let’s take a look at two JAK inhibitors that are leading the pack in clinical trials, following in Olumiant and Litfulo’s footsteps.

Deuruxolitinib

Sun Pharma is developing a JAK inhibitor called deuruxolitinib (CTP-543). It’s a twice-daily oral medication being studied for adults with moderate-to-severe alopecia. Phase 3 study data presented in March 2023 was encouraging about how well it helps reverse scalp hair loss.

The manufacturer initially intended to apply for FDA approval in the first half of 2023. But deuruxolitinib’s progress hit a setback. The higher 12 mg dose of the medication has been linked to rare cases of blood clots. The lower 8 mg dose has not been associated with this risk. Sun Pharma is now collaborating with the FDA to determine next steps.

Jaktinib

Suzhou Zelgen Biopharmaceuticals is developing their own JAK inhibitor, called jaktinib, for moderate-to-severe alopecia. It’s a twice-daily oral medication.

Jaktinib is being studied in two phase 3 clinical trials (Study 1, Study 2). Interim study results haven’t been announced yet, but the phase 3 studies are expected to finish by December 2023. A topical version of jaktinib is also in a phase 1/2 clinical trial.

Other drug classes

JAK inhibitors aren’t the only medications in development. 

Pfizer is developing a once-daily oral medication called etrasimod. This medication is a selective sphingosine-1-phosphate (S1P) receptor modulator, which works on specific cells in your immune system. The company finished a phase 2 trial in mid 2023, but it will likely be a few years before the medication potentially makes it to the market. 

Here are other examples of non-JAK treatments in development:

• Coacillium (LH-8), a topical solution with positive results from a phase 2/3 trial

• Diphenylcyclopropenone (DPCP), an immunotherapy ointment in a phase 3 trial

• Farudodstat, a twice-daily tablet in a phase 2 trial

• KL130008, an oral capsule in a phase 2 trial

• Daxdilimab (HZN-7734), an under-the-skin injectable medication in a phase 2 trial

• EQ101, formerly BNZ-1, an intravenous (IV) medication in a phase 2 trial

Why is alopecia areata so difficult to treat?

Many of the medications listed above may improve hair growth for some people with alopecia, but not everyone. For others, it can be a trial-and-error process until they find something that works.

Some alopecia medications can cause serious, sometimes dangerous side effects. As a result, some healthcare professionals think certain medications might be too risky and costly to be used for hair regrowth. Your healthcare provider can tell you which treatment options are safe for your situation.

Health experts are currently looking at additional medication options that can promote hair growth and limit bothersome side effects. 

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Written by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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