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JAK Inhibitors May Treat Nail Dystrophy from Alopecia Universalis

Xeljanz Used to Treat Alopecia Universalis in Yale Hair Loss Treatment StudyAdding to the misery of some people who have the autoimmune disorder Alopecia Areata, which manifests itself as sudden hair loss, is an unsightly and sometimes painful dystrophy of the fingernails. These ridged and misshapen nails are particularly associated with more extreme cases of Alopecia, especially Alopecia Totalis in which all hair on the head is lost, and Alopecia Universalis, which causes total hair loss on the entire body.

Until now, whilst treatments such as high strength minoxidil may produce significant hair regrowth in cases of mild to moderate Alopecia Areata, there has been no treatment for any accompanying nail dystrophy. However, now a new study using the seemingly revolutionary drug tofacitinib, a JAK inhibitor, has opened up hope for those affected worldwide.

Impressive results

Nail Dystrophy Treated by Tofacitinib in Clinical Trials

Images from the study published in the JAMA Dermatology report show a participants nails before treatment with tofacitinib and then again five months later where the previous brittle, ridged condition has almost entirely cleared

According to a new study published by the JAMA Network’s Dermatology division and carried out by American researchers Arjun Dhayalan BS and Brett A King MD, PhD, their tests of the drug on three patients who all have Alopecia Universalis produced impressive results.

The first test involved a man in his 20s who was treated with the drug twice a day for two months. The concentration was then increased because he was not experiencing hair growth – a key reason he was involved in the trial in the first place.

The second involved a woman in her 40s, who was also treated with tofacitinib 5g twice a day for two months. The third was another man in his twenties who was given the same dosage.

All three patients’ nails were significantly improved after five to six months, say the authors of the study, who also reported hair growth in the second two patients. Additionally, they state that the first patient did not experience returning nail dystrophy 10 weeks after he stopped taking the drug (the other two continued to take it).

The authors conclude that: “The outcomes in the three patients described here suggest that tofacitinib and other JAK inhibitors may be effective in the treatment of severe nail dystrophy associated with Alopecia Areata.”

Promisingly, the authors also state that “Tofacitinib was well tolerated in all three cases, and infections, cytopenias, transaminitis, decreased renal function or increased lipid levels were not observed.

What is a JAK inhibitor?

Hair Growth Cycle DiagramThe full name for these type of drugs is Janus kinase inhibitors, and their role is to suppress the functionality of JAK enzymes within the body. You may have seen them written about under their brand-names: Jakafi (also known as Ruxolitinib) and Xeljanz (Tofacitinib).

The reason these drugs have been making such great waves in the field of hair loss is because certain JAK enzymes are involved in the hair growth cycle. The drugs have proven effective at targeting the enzymes inside hair follicles which cause them to lie dormant in cases of Alopecia Areata. As a result, they have demonstrated an ability to kick-start the follicles out of the telogen (resting) phase and back into active growth.

There are a number of trials currently underway to test the long-term possibilities of JAK inhibitors as treatments for various forms of Alopecia Areata – including the most extreme form of Alopecia Universalis – with oral and topical applications both showing promise.

While these developments are certainly very encouraging, excitement should be tempered until long-term testing has proven not just these drugs’ efficacy, but also their safety.


Circ The Belgravia Centre Hair Loss Treatment for Alopecia AreataThe Belgravia Centre

The Belgravia Centre is the leader in hair loss treatment in the UK, with two clinics based in Central London. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the UK or the rest of the world. View our Hair Loss Success Stories, which are the largest collection of such success stories in the world and demonstrate the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time for our hair loss helpline or to arrange a free consultation.


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