Baricitinib treatment for alopecia areata | Dr Anastasia Therianou MD, PhD
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Is baricitinib (Olumiant) the powerful new treatment for moderate to severe forms of alopecia areata you’ve been waiting for?

March 23, 2023
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It is thought that alopecia areata impacts one in 1000 people in the UK alone, and over seven million sufferers in the US, yet those with the condition might still find themselves desperately searching for answers and treatments for years. Many feel that the disease harms their confidence, their sense of self and their general mental health, and this often increases with the severity of the hair loss they experience.

So, if you’re struggling, you’re not alone, and the good news is that a new medication now means that treatment is much more accessible than ever before.

What is alopecia areata?

Alopecia areata is caused when the immune system mistakenly attacks hair follicles and causes patches of hair loss. The disease seems independent of ethnicity but can be hereditary, with a family history of Alopecia Areata and/or other autoimmune conditions present in around 10–25% of patients.

Hair can be lost from any part of the body, though alopecia areata predominantly affects the head and face. The good news is, that with early treatment, alopecia areata can be reversible. About 80 per cent of people with the condition, especially mild cases, find that their hair regrows without treatment within a year.

Dr. Anastasia Therianou is a Certified Consultant Dermatologist and hair disorders expert, so a consultation at her clinic is the best option if you are experiencing hair disorders. We help many patients daily with a variety of medical skin conditions in our dermatology clinic in Harley Street. 

Treating alopecia areata with baricitinib

Baricitinib is a drug known as a Janus kinase (JAK) inhibitor, which works by blocking the activity of pathways of inflammation involved in autoimmune diseases such as eczema, rheumatoid arthritis, and more recently, alopecia areata. It suppresses the immune system to prevent it from attacking the hair follicles and, though its impact is not immediate, most people start noticing the effects about two to eight weeks after they start taking the medication.

Full benefits can be expected between three to six months, so though it is not a quick fix, it is certainly one of – if not the most – effective treatments available today.

What forms of alopecia areata does baricitinib work for?

In June 2022, baricitinib was licensed to be used on moderate to severe forms of alopecia areata and is mainly prescribed to patients who have tried standard immunosuppressive treatments but have either seen little to know benefit from them or found they were intolerant to them.

How do I take baricitinib?

Baricitinib is a tablet taken by mouth once daily with or without food and at any time of the day, as advised by a professional. Your exact dosage (2mg or 4mg) will be dictated by your personal medical history, age and severity level of alopecia areata.

baricitinib for female

Does baricitinib impact fertility, pregnancy or breastfeeding?

It is medically advised not to take baricitinib if you are either pregnant or breastfeeding, and women who have the potential to conceive should ensure that they are using a contraception method with high efficacy during the entire course of treatment and for seven days after.

Currently, there is little research around baricitinib’s impact on fertility in humans, however studies on animals suggest that there is potential for the medication to slightly decrease fecundity.

What are the possible side effects?

Most patients tolerate it well with little or no side effects, however, common side effects can include infections of the upper respiratory system such as nasopharyngitis, or an infection of the skin known as herpes zoster, or urinary tract infection. Folliculitis or acne can also occur, as can thrombosis of the veins ( blood clots), especially in patients who are higher risk. 

Monitoring of blood in patients is also necessary as aAnemia, increased muscle enzyme levels, increased fat levels in the blood can happen as a result of the medication. Finally, baricitinib, as with every other drug of the same group (JAK inhibitors), may increase the risk of lymphoma, however the studies available to date, are still too short to address this, and we will know more in the next few years. 

Can I drink alcohol while taking baricitinib?

In short, yes you can. However, it is best to keep in line with NHS guidance, which states that to keep alcohol-related health concerns low, it is safest to drink no more than 14 units of alcohol per week (equivalent to 6 pints of average -strength beer or 10 small glasses of lower-strength wine).

What if I have mild signs of alopecia areata?

As baricitinib is only licensed for moderate to severe forms of the disease, those with mild cases are not suitable for this kind of treatment. However, there are other options available that Dr Anastasia and her team would be more than happy to discuss with you, you can contact them here. 

Baricitinib has been approved for alopecia areata in USA, Europe and Japan since summer 2022, however the National Institute for Health Care and Excellence (NICE) in the UK, has recently outlined that they do not recommend baricitinib for routine commissioning on the NHS for treating severe alopecia areata in adults. Patients who decide to pay for baricitinib and not get it through the NHS service but through private sector, can still fulfil their prescriptions from online pharmacies at a discounted price.

If you would like to discuss this treatment option further, or you want to see what other treatments are available, you can contact Dr Anastasia ‘s Therianou dermatology clinic by phone: 02038695134 or 02034684884 or by sending an email to info@drtherianou.com

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