Olumiant® Alopecia Areata: How Baricitinib Treats Hair Loss

Alopecia areata is an autoimmune disorder that causes hair loss. If you have it, your provider might prescribe baricitinib. But is baricitinib alopecia treatment effective? And is it safe?

Alopecia areata causes patchy hair loss on your scalp and body. While your hair might grow back, the condition can return, impacting your confidence and quality of life. The good news? Treatments like baricitinib, also known as Olumiant®, can make a big difference in managing alopecia areata. 

Below, we cover everything you need to know about using Olumiant for hair loss — from the side effects to the benefits and beyond.

Baricitinib is a once-daily, prescription medication. It’s also available under the brand-name Olumiant.

It’s part of a class of medications known as oral janus kinase inhibitors (or JAK inhibitors). Janus kinases are enzymes that regulate certain immune cell functions in the body — in particular, cytokines, which control inflammation. When these immune cells aren’t working properly, they can cause autoimmune diseases. 

Baricitinib blocks the janus kinase subtypes JAK1 and JAK2. Through the inhibition of JAK signaling, baricitinib can prevent an out-of-control immune system from attacking healthy cells. 

Baricitinib has U.S. Food and Drug Administration (FDA) approval to treat:

• Alopecia areata

• COVID-19

• Rheumatoid arthritis 

Healthcare professionals also sometimes prescribe it off-label to treat:

• Atopic dermatitis

• Psoriatic arthritis

• Vitiligo

For alopecia areata, you’ll usually start with a daily dose of 2 milligrams (mg). If you experience complete scalp hair loss or don’t see results, your provider might bump up the dosage to 4 mg per day. 

What about Oluminant for male pattern baldness? Is it an option for genetic-related hair loss? No. Oluminant isn’t a proven treatment for male pattern baldness. 

Yes, baricitinib is an effective, FDA-approved treatment for alopecia areata backed by clinical studies.  

Two placebo-controlled clinical trials, BRAVE-AA1 and BRAVE-AA2, looked at the effectiveness of baricitinib for alopecia areata. 

In these trials, participants with alopecia areata received either a placebo or 1 mg, 2 mg, or 4 mg of baricitinib daily. Researchers used the Severity of Alopecia Tool (SALT) to measure their condition.

The data suggests that baricitinib effectively treats severe alopecia areata, including alopecia universalis, which causes total hair loss on the scalp, face, and body. 

Participants using baricitinib showed increased hair regrowth and lower SALT scores after 52 weeks of treatment.  

These studies suggest that baricitinib may promote hair regrowth in people with severe alopecia areata, depending on the initial severity of the condition. 

One caveat: A follow-up study found that 80 percent of patients who stopped using baricitinib lost benefit after discontinuation.  That means you’ll likely need to keep taking it to maintain hair regrowth. 

Although these findings are promising, we need more long-term research to understand this medication’s full potential and limitations.

Because baricitinib is an immunosuppressant drug, it weakens your immune system, increasing your risk of:

• Illness

• Serious infections

• Other health issues 

People with tuberculosis, HIV, fungal infections, and other ongoing medical issues shouldn’t take baricitinib. 

Baricitinib side effects can include:  

• Acne

• Headaches

• Nausea

• Vomiting

• Abdominal pain

• Low white blood cell count (neutropenia)

• Increased cholesterol levels

Baricitinib might also increase your risk of adverse events like:

• Cardiovascular events

• Lymphoma and other cancers

• Deep vein thrombosis or blood clots

• Anemia

• Bone marrow issues

• Upper respiratory tract infections

• Urinary tract infections 

• Creatine phosphokinase elevation 

• Shingles (herpes zoster)

Before prescribing baricitinib, a healthcare professional can help you weigh its pros and cons. They’ll also check for any risk factors, like heart issues. 

One last note on safety: it’s important to take your medication as prescribed. Don’t change your dose of baricitinib without consulting a healthcare professional. 

Baricitinib isn’t the right fit for everyone dealing with alopecia areata. For some, it may not be effective or safe.

Thankfully, you have other options to treat this type of hair loss, including:

• Topical anthralin or corticosteroids,  which you apply directly to bald spots

• Corticosteroid injections, which help control your body’s immune response

• Minoxidil, which promotes hair growth by stimulating blood flow to hair follicles 

Depending on the severity of your alopecia areata, your healthcare provider might suggest topical immunotherapy treatments or another JAK inhibitor.  

And if you’re dealing with male pattern baldness on top of alopecia areata, you might benefit from using finasteride.

If you have a condition like alopecia areata, baricitinib (aka Olumiant) might help regrow hair and prevent further hair loss.

Let’s recap what we know about Olumiant alopecia areata treatment:

• Alopecia areata is a type of autoimmune disease-related hair loss. It happens when your immune system attacks your hair follicles, leading to bald spots on your scalp and body. 

• Baricitinib is an immunosuppressant. It works by blocking specific immune system enzymes and reducing your body’s autoimmune response. 

• Baricitinib alopecia areata treatment is effective but it’s not for everyone. Using immunosuppressant drugs can make you more prone to infections and illnesses. 

Considering baricitinib for treating your alopecia areata? A licensed clinician can help you weigh the pros and cons. 

Want to learn about other ways to address hair thinning? Let us connect you with a healthcare professional to discuss your hair loss treatment options. You can start by taking our free hair quiz.