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Janus Kinase JAK inhibitors tofacitinib grow hair - Dr. Christiano



Interestingly I got on tofacitinib six weeks ago to try to treat vitiligo. These drugs are turning out to be huge success stories in a variety of autoimmune disorders. A few points:

First, in the last two weeks I have noticed less hair fallout than usual. Hard to judge anything on such a short-term basis. The article does not clarify whether oral administration might produce results. Depends on what organs the drugs become active in, but since it is being used to treat a skin disorder, vitiligo, I would assume it likely reaches the follicles, in some amount.

Second, so you know, these drugs are very expensive if you don’t have insurance.

Lastly, it is obviously unclear whether there is any new hair growth from this drug, based on this study. It looks as if it just activates present hairs to speed up the growth cycle, which might cause them to fall out faster as well. It’s difficult to draw a lot of conclusions at this point, but if I find an appropriate topical vehicle I might crush some up and see what happens. Suggestions for the vehicle are welcome.


Very interesting Christopher. Let us know if it improves your vitiligo and if you get any side effects. Did your doctor prescribe you the drug? Dr. Christiano also seems to have started a new company per this:



I think this may be promising (and I am usually very skeptical of topicals and chemicals these days because most of them produce inconsistent results).

While Janus Kinases have a number of different roles, it may be that they’re involved in hair growth signaling (perhaps downstream of the prostaglandins?)

Dr. Christiano’s statement that some drugs and signaling agents which activate the growth phase of dormant follicles (I think you can include Minoxidil and PGE2 in this category), by experience, usually work in an uneven and sometimes patchy or unpredictable way, as opposed to this JAK inhibitor which is producing even, very substantial hair growth by switching the growth phase from telogen to anagen.

Remember that the very final step in most kinds of hair loss (different types of alopecias including MPB) entails signaling the follicle to have much shorter growth phase, and remain in dormant phase for longer and longer periods. So ultimately when you have MPB, the affected follicles have insignificant growth phases and very long resting phases. That results in shedding, shorter and shorter, finer and finer hairs until the follicle no longer produces a hair.

DHT sensitivity seems to trigger a pathway which involves things like PGG2 Synthase, excess PGD2 production (and possibly suppressed PGE2), and a few other things, all of which ultimately suppress the activiity of stem cells, reducing the numbers of progenitor and DP cells, which mimics a dormant follicle.

Now it looks like Janus Kinase (JAK) is involved. What is very interesting here as Dr. Christiano says, is the evenness and extent of the regrowth, which to me, suggests that JAK is located very far downstream in this complicated mess. Maybe it’s the final biochemical step, or one of the last, before stem cell suppression?


I agree, this particular development seems much more significant - and promising - than the usual ‘mouse’ studies. Here’s hoping.



I found this Pilot Study to Evaluate the Efficacy of Ruxolitinib in Alopecia Areata done in 2013.

Funny but apparently they didn’t publish the result. If so why was that?



Actually if you watch Dr. Christiano’s long video on the original post where she gives a detailed explanation, she says they’ve found that the drug has an anti-immune effect, in that it suppresses T-cells, but that the surprising finding they made was that it also has a non-immune effect, in that it directly activates stem cells and switches the follicle out of resting phase into anagen or growing phase. This is something that was totally unexpected and it’s not surprising Dr. Cotsarelis didn’t expect it.

In light of that, Dr. Christiano indicated in her video that this JAK inhibitor should work just as well for MPB as it will for alopecia areata.


Are there JAK inhibitors in the marketplace or soon to be in the marketplace? The drug would have to be potent and pure. We would have to be able to turn it into a topical solution.


Both roxafitinib and tocafitinib are approved and available on the market right now for autoimmune disorders like psoriasis.


I will get excited when I see hair growing on humans! How many times have we heard this? They always say “more studies are needed”. Take one human and try it. Just one. If a bald head returns to a full head of hair, then I will believe.


This sounds pretty exciting-of course if it works on humans. The great thing is that they’re already FDA approved…as someone mentioned earlier, just has to get turned into a topical.

At the same time though, I think its best they go through with clinical trials-just in case they lead to some unexpected adverse reaction.

Also I’ve heard these drugs are very expensive, but I’ll bet that’s because the market is very limited.

Hopefully the makers of the drug will realize they can make a vast amount of money due to hundreds of millions of balding potential customers and make it affordable/cheaper.

It’s true what they say, beauty is wasted on the youth. I had a full head of hair in my late teens and 20s-I could’ve take better advantage of it, but you never realize how fast time flies and how quickly one’s looks can change-I’m in my early 40s now.

If I could get my hair back and get back into shape (which isn’t hard), then I’ll get a second chance with the sexy ladies and do it right this time. God I can’t believe how stupid I was and squandered what I had.


nothing to hype for us. maybe for mice or for ppl suffering alopecia areata

right now it`s not very interesting for us


Matigol, did you watch Dr. Christiano’s video? She mentions it will likely work for MPB. That’s the whole point of this new discovery, that it works better to regrow hair as a topical than orally, which is not what was originally thought. Otherwise JAK inhibitors would be old news.


no, I didn’t watch the video. But don’t they always mention that a new discovery MAY work in humans and not only in mice? or it MAY work for AA.

My expectations are not really big. But let`s hope.


Any volunteer to get ruxolitinib (the other one has terrible side effects) and try it?


Does that mean she’s not working on the 3D culturing of dermal papilla cells anymore? (That would be a shame, as I thought that was a much more promising approach.)


Also, how long have these drugs been around to treat vitiligo? Are they used topically to treat vitiligo? (If so, then surely we would know by now if they had any effect on hair growth.)


On your question about Dr. Christiano’s 3D cloning research, just a guess, but I suspect that she knows that Sanford-Burnham and possibly Shiseido may have rendered that somewhat irrelevant.

With respect to the drugs like tofacitinib fot vitiligo, yes I think they were being given orally, strange as it may seem.

One possible very negative side effect I could potentially see happening from this, though, is possibly causing a “rebound vitiligo”-like syndrome if the drug is withdrawn, even in a healthy person who’s never had vitiligo. I have absolutely no idea if this would happen, but there are many examples of drug withdrawal/rebound effects in pharmacology.


[quote][postedby]Originally Posted by News[/postedby]
Does that mean she’s not working on the 3D culturing of dermal papilla cells anymore? (That would be a shame, as I thought that was a much more promising approach.)[/quote]

As she stated in a previous interview, very difficult to get funding for cell culturing. Drugs that are already approve that show somewhat hope are more likely to get funded. The cell culturing is still a crap shoot. Hopeful but not there yet.


I am not an expert, but it seems that molecular size makes possible a dermal administration of the drug without any problem… Any volunteer ?