It’s okay if you’re losing a little hair every day while brushing or washing your hair; however, if you’re noticing excessive amounts of loose hair, it may be due to alopecia, an autoimmune disorder causing small bald patches. As per the National Alopecia Areata Foundation, over 6.8 million Americans may suffer from this form of hair loss. But the good news is that alopecia areata now has a cure with an oral tablet, Olumiant (baricitinib). 

The U.S. Food and Drug Administration (FDA) has approved Olumiant tablets for treating alopecia areata in adult patients. It is the first-of-its-kind drug for systemic therapy of alopecia areata, which means it treats the entire body and not just a specific area.

Let’s read more about this wonder drug.

What Is Alopecia Areata?

As the name suggests, alopecia areata is an autoimmune disorder that affects the hair follicles, resulting in hair loss. Typically, hair loss on the scalp is accompanied by discrete bald patches that can occur on any part of your body. In Latin, alopecia means hair loss, and areata means a patch. Anyone from all races, ages, and genders can develop alopecia, although most cases occur in people before they reach their 30s. There are several variations of alopecia areata, such as:

  • Alopecia areata totalis 
  • Alopecia universalis 
  • Ophiasis
  • Ophiasis inversus
  • Diffuse alopecia areata

Symptoms of Alopecia Areata

The most common symptom of alopecia is severe hair loss. In most cases, it appears as small coin-sized patches that start occurring due to hair fall. The hair starts falling suddenly with itching and inflammation on the scalp, and the condition becomes severe within a few weeks. Hair sometimes grows back but falls from another part of the scalp making a new patch. In winter, the hair fall increases. Alopecia affects not only hair but also your fingernails and toenails. White spots, lines, and dents appear on your nails. They lose their shine and become rough, thin, and brittle.

Causes of Alopecia Areata

Alopecia areata occurs when hair follicles shrink and dramatically slow down hair production after white blood cells attack them. Why the immune system targets hair follicles in this way is still unknown. Having a close family member with the disease increases the risk of developing alopecia areata. 

Other than having a family history of alopecia areata, many people with alopecia areata also have atopy (an autoimmune disorder associated with allergy and hypersensitivity), thyroiditis, and vitiligo. The idea that stress causes alopecia areata is not supported by much scientific evidence. A lot of stress can trigger the condition, but most recent research points to a genetic basis for the disorder.

How Does Olumiant Work?

Olumiant is a drug that inhibits the enzyme Janus kinase (JAK) [1] and works on the inside of the body. It disrupts an immune signaling pathway that contributes to alopecia areata. Olumiant’s therapeutic effects may be associated with suppressing immune signals, though there is no scientific proof yet. Olumiant is already an approved medication for rheumatoid arthritis. Rheumatoid arthritis patients with moderate to severe activity can take Olumiant as a treatment.

The severity of the alopecia tool measured the patients with more than six months’ scalp hair loss. They were studied in two double-blind, placebo-controlled randomized trials to determine Olumiant’s efficacy and safety. Using Olumiant with another JAK inhibitor, a biologic immunomodulator, cyclosporine, or other potent immunosuppressants is not recommended. Olumiant (baricitinib), a once-daily pill, is recommended as a systemic treatment for adults with severe alopecia areata. It is available in 4-mg, 2-mg, and 1-mg tablets.

Possible Side Effects of Olumiant

Olumiant comes with warnings and precautions that the patients should be closely monitored during and after treatment. They should also be evaluated for active tuberculosis and tested for latent tuberculosis before taking Olumiant due to the potential for viral reactivation. The package insert for Olumiant warns of serious infections, mortality, malignancies, major adverse cardiovascular events, and thrombosis. Pneumonia, herpes zoster, and urinary tract infections were the most common serious infections reported with Olumiant.

Before beginning Olumiant therapy, consider the risks and benefits in patients with chronic or recurrent infection, those exposed to tuberculosis, those with a history of severe or opportunistic infection, those living or traveling in endemic regions for tuberculosis or mycoses, or those with underlying conditions that may predispose them to infection. Olumiant should not be prescribed for patients with active infections, including localized infections. 

There is a possibility that Olumiant may increase your risk of lymphoma and other cancers, such as skin cancers. It may also increase the risk of major cardiovascular events, such as heart attack, which could cause blood clots in your lungs, legs, and arteries. In addition, it may also cause allergic reactions, such as rashes, trouble breathing, dizziness, or swelling of your lips, tongue, or throat. Sometimes it may cause inflammation in the stomach and intestine.

Other Treatments for Alopecia

Olumiant is the first oral medicine approved by the FDA for treating alopecia. A patient can use a few more treatments if his doctor prescribes them. Below are some of these treatments:

  • Corticosteroids: These are anti-inflammatory medicines that are advised for treating autoimmune diseases. They can be injected into the scalp, applied to the skin as a cream, lotion, or ointment, or taken as a pill. This medication works slowly and thus takes a long time to cure and start hair regrowth.
  • Topical immunotherapy: This treatment is given when you have severe hair loss. A chemical is applied on the scalp, which causes inflammation and irritation to the skin. This, in turn, regulates hair growth and stimulates new hair to grow. Ongoing treatment is required to promote new hair growth regularly.
  • Minoxidil: This is applied on the scalp, and it takes around 12 weeks to see any new hair growth. This treatment, therefore, takes a long time to see results. 

Alopecia is medically harmless, but the psychological implications can be severe. As a result, Olumiant’s approval is significant for people suffering from alopecia areata and the experts advocating it. It enables many people to access a cure for this disorder and may allow them to regain their hair and enhance their overall quality of life.


1. Upham, Becky. (June 15, 2022). FDA Approves New Treatment Olumiant for Hair Loss From Severe Alopecia Areata.

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