Healthy, young adults can usually tolerate corticosteroid pills with few side effects. However, doctors do not prescribe corticosteroid pills as often as other treatments for alopecia areata, because of the health risks and side effects associated with using them for a long period of time. It’s important to talk to your doctor about your goals for treatment and possible side effects of the medication, to be sure the benefits of using corticosteroid pills in your case are greater than the risks. As with other options, hair regrown with corticosteroid use may fall back out once treatment is stopped.
The latest breakthrough with alopecia areata is the discovery of the response of alopecia areata to the Janus kinase (JAK) inhibitors. This was discovered serendipitously when patients with alopecia areata were treated for other conditions with JAK inhibitor drugs and showed regrowth of hair. The two JAK inhibitor drugs that have have been found to help with alopecia areata are tofacitinib and rituximab which are used for arthritis and blood disorders such as myelodysplasia and lymphoma. Both these drugs are very expensive and can cause side effects and experience has shown that on ceasing the medication the regrown hair often falls out. The latest area of research in this field is to develop a topical formulation of one of the JAK inhibitor drugs to avoid side effects and hopefully also reduce topical minoxidil is not a treatment as such for alopecia areata it can be used in conjunction with other treatments to try to hasten the regrowth of hair once the inflammatory infiltrate has been turned off.