Women's Health May 15, 2026 0 Comments

The Untold Truth About Beating Alopecia Areata—What Doctors Don’t Want You to Know!

Ever felt like your hair has a mind of its own—one day showing up for work, the next deciding to take an unexpected vacation? If you’re one of the nearly 7 million Americans grappling with alopecia areata, you know this unpredictable hair saga all too well. Treating hair loss can feel like chasing smoke, especially when no clear end is in sight. And when hope starts to flicker, or patience runs thin, it’s only natural to wonder: is there a better way forward? For years, severe alopecia areata left many without FDA-approved options, stuck in a frustrating loop of limited treatments and uncertain results. But hold up—times are changing. New breakthroughs have landed on the scene, shaking up the treatment playbook and offering fresh possibilities for those struggling with this complex autoimmune condition. If you’ve been managing alopecia areata for what feels like forever, it might just be time to revisit your strategy and explore what’s new in the fight against hair loss. Ready to uncover the latest insights and find out if there’s a path that could finally bring your hair back to the spotlight? Let’s dive into the essentials and the emerging solutions that could turn the tide. LEARN MORE

10 min read

Sponsored by Pfizer. Dr. Soung was compensated for her time.

If you’re among the nearly 7 million people in the United States living with alopecia areata, you know that treating hair loss can be an unpredictable, long-term journey. But if you’re struggling to see hope on the horizon—or you’ve just run out of patience—there may be another option.

For many years, no FDA-approved treatments existed for people with severe alopecia areata, leaving them with limited options. But the treatment landscape has evolved, and if your alopecia areata is severe, it could be time to talk to your dermatologist about revising your treatment plan.

Below are answers to some important questions about alopecia areata—no matter how long you have been managing it—and what you need to know about emerging approaches to its management.

What should I know about alopecia areata?

Even if you’ve managed severe alopecia areata for years, it can help to revisit what’s driving the disease, especially as additional treatments have become available.

Alopecia areata is a chronic autoimmune disease where a person’s immune system triggers inflammation that mistakenly attacks their hair follicles, causing their hair to fall out.

“This autoimmune component sets alopecia areata apart from other forms of hair loss, since chronic inflammation targets the follicle and interrupts hair growth rather than causing permanent damage,” explains Jennifer Soung, MD, a board-certified dermatologist in Santa Ana, Calif., who specializes in medical dermatology and clinical research.

“This is a complex disease driven by a combination of genetic predisposition and environmental triggers—including physical or emotional stress—that can bring underlying hair loss to light,” Dr. Soung says. And that makes its treatment more complex.

Stress is also one of the factors that can affect alopecia areata—but it isn’t the cause. Stress isn’t considered a primary driver of alopecia areata. “Many patients feel like they’re causing their own hair loss [by stressing over it],” Dr. Soung says. “While stress can certainly impact it, it’s not the cause—you’re not causing your own hair loss.”

Why does living with alopecia areata remain challenging–even if I’ve been managing it for years?

As an autoimmune disease, alopecia areata can include unpredictable periods of hair loss and regrowth. It can be frustrating to feel like your hair is maybe starting to come back, only to worry that a new patch could show up at any moment.

What’s often missing, Dr. Soung notes, is acknowledgment that this unpredictability isn’t cosmetic; it’s a sign of an active autoimmune disease.

“Many patients come in, they feel embarrassed because they feel that they’re being too vain if they care about their hair,” she says. “It’s OK to care about your hair. This is a medical condition. It is not a cosmetic condition. Alopecia areata isn’t just about hair, it is a chronic health condition.”

There are practical concerns to deal with, too. While wearing a wig works for some people to restore the appearance of their old hair, wearing a wig can be itchy, uncomfortable, and potentially take activities like swimming off the table. You might also struggle with how to reveal your alopecia areata to someone who might eventually see you wigless, like a new romantic partner.

What treatments are available? What can I do if my current treatment isn’t working?

Alopecia areata has traditionally been treated with oral, topical, or injectable steroids that work by decreasing immune activity that drives inflammation and attacks the hair follicles. But these meds weren’t specifically designed to treat the disease. If you are still struggling with severe alopecia areata, it’s worth talking with your dermatologist about other options.

One option is Pfizer’s LITFULO (ritlecitinib), a once-daily prescription pill approved by the FDA in 2023 to treat severe alopecia areata in adults and adolescents ages 12 and up.

LITFULO does have some potential risks. LITFULO may cause serious side effects, including serious infections, increased risk of death, cancer and immune system problems, major cardiovascular events, blood clots, and allergic reactions. Learn more about these risks and additional Important Safety Information below. A dermatologist will discuss the screening and monitoring needed before and during treatment, as well as your medical history including any medications you are taking.

How does LITFULO work?

LITFULO is not a steroid, cream, or injection. It’s a once-daily pill that binds to select proteins within immune cells, which can reduce immune activation and the inflammatory signaling involved in alopecia areata.

Everyone’s experience with severe alopecia areata may be different, so patients should speak with their doctor about potential treatment options and what that treatment journey could look like. Hair growth is never an overnight process. “It could take six months before you see regrowth,” Dr. Soung says. “The waiting can be difficult, but hair regrowth takes time.”

While individual results can vary, a clinical trial found 23 percent of people taking LITFULO saw 80 percent or more scalp hair coverage in just under 6 months versus 1.6 percent on placebo.

In clinical trials, the most common side effects seen for those taking LITFULO included headache; diarrhea; acne; rash; hives; inflamed hair pores (folliculitis); fever; eczema; dizziness; shingles; decreased red blood cell counts; and mouth sores, redness and swelling of the lining of your mouth. These are not all of the possible side effects of LITFULO. See below for more Important Safety Information.

How can I start a conversation with my doctor to decide on a treatment?

First, make sure you’re seeing the right specialist: a board-certified dermatologist you feel comfortable with who has experience treating alopecia areata (not all do!). LITFULO’s Dermatologist Finder tool can help you locate one.

“When a patient comes to see me, I ask them to tell me about any concerns they have with their alopecia areata and what their treatment goals are,” Dr. Soung says. “It really gets to how severe it is and how I can help you.”

Treatment options aren’t one-size-fits-all. Like with any medication, it’s important to have an in-depth conversation with your dermatologist about whether LITFULO is the right choice for you. If you are experiencing hair loss due to severe alopecia areata, even if you have already tried other treatments, LITFULO could be an option to regrow your hair.

“I think it’s been a really helpful addition to my toolbox and a medication with the potential to help patients regrow their hair,” Dr. Soung says. “I want to give patients options. Understanding their concerns and how severe alopecia areata has impacted them helps us explore treatment options, like LITFULO.”

Visit LITFULO.com for more information and resources, including a Doctor Discussion Guide you can fill out and bring to your next appointment. Everyone’s experience is different, so speak with your healthcare provider about potential treatment options for severe alopecia areata.

IMPORTANT SAFETY INFORMATION

LITFULO may cause serious side effects, including:
Serious infections. LITFULO can lower the ability of your immune system to fight infections. Do not start LITFULO if you have any kind of infection unless your healthcare provider tells you it is okay. Some people have had serious infections while taking LITFULO or other similar medicines, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body and have been hospitalized. Some people taking similar medicines to LITFULO have died from these infections. You may be at a higher risk of developing shingles (herpes zoster).

Your healthcare provider should test you for TB before starting treatment with LITFULO and should watch you closely for signs and symptoms of TB during treatment with LITFULO.

Before and after starting LITFULO, tell your healthcare provider if you think you have an infection, are being treated for one, or have symptoms of an infection, including:

fever, sweating, or chills
muscle aches
cough or shortness of breath
blood in your phlegm
weight loss
warm, red, or painful skin or sores on your body
diarrhea or stomach pain
burning when you urinate or urinating more often than usual
feeling very tired

LITFULO can make you more likely to get infections or worsen infections you have. If you get a serious infection, your healthcare provider may stop treatment with LITFULO until your infection is controlled.

There is an increased risk of death in people 50 years of age and older who have at least one heart disease (cardiovascular) risk factor and are taking a Janus kinase (JAK) inhibitor. LITFULO is a kinase inhibitor medicine.

Cancer and immune system problems. LITFULO may increase your risk of certain cancers by changing the way your immune system works. Lymphoma and other cancers, including skin cancers, can happen. People taking JAK inhibitors have a higher risk of certain cancers including lymphoma and lung cancer, especially if you are a current or past smoker. Follow your healthcare provider’s advice about having your skin checked for skin cancer during treatment. Tell your healthcare provider if you have ever had any type of cancer.

There is an increased risk of major cardiovascular events such as heart attack, stroke, or death in people 50 years of age and older who have at least one heart disease (cardiovascular) risk factor and are taking a JAK inhibitor, especially if you are a current or past smoker.

Get emergency help right away if you have any symptoms of a heart attack or stroke while using LITFULO, including:

discomfort in the center of your chest that lasts for more than a few minutes, or that goes away and comes back
severe tightness, pain, pressure, or heaviness in your chest, throat, neck, or jaw
pain or discomfort in your arms, back, neck, jaw, or stomach
shortness of breath with or without chest discomfort
breaking out in a cold sweat
nausea or vomiting
feeling lightheaded
weakness in one part or on one side of your body
slurred speech

Blood clots. Blood clots in the veins of your legs (deep vein thrombosis, DVT), lungs (pulmonary embolism, PE), or eyes can happen in some people taking LITFULO. This may be life-threatening. Blood clots in the veins of the legs and lungs have happened more often in people 50 years of age and older with at least one heart disease (cardiovascular) risk factor taking a JAK inhibitor. Tell your healthcare provider if you have had blood clots in the past.

Stop taking LITFULO and get medical help right away if you have any signs and symptoms of blood clots, including swelling, pain or tenderness in one or both legs; sudden, unexplained chest or upper back pain; shortness of breath or difficulty breathing; or changes in vision, especially in one eye only.

Allergic reactions. Symptoms that may mean you are having an allergic reaction have been seen during treatment with LITFULO. Some of these reactions were serious. Stop taking LITFULO and get emergency medical help right away if you have symptoms of allergic reaction, including hives; rash; trouble breathing; feeling faint or dizzy; or swelling of your lips, tongue, or throat.

Changes in certain laboratory test results. Your healthcare provider should do blood tests before you start taking LITFULO and during treatment to check your lymphocyte and platelet counts and liver enzyme and creatine phosphokinase (CPK) levels. You should not take LITFULO if your lymphocyte counts or platelet counts are too low or your liver tests are too high. Increased CPK levels in the blood are common with LITFULO and can also be severe. Your healthcare provider may stop treatment for a period of time if there are changes in these blood test results.

Do not take LITFULO if you are allergic to ritlecitinib or any of the ingredients in LITFULO. See the Medication Guide for a complete list of ingredients.

Before taking LITFULO, tell your healthcare provider if you:

have an infection, are being treated for one, or have one that won’t go away or keeps returning
have diabetes, chronic lung disease, HIV, or a weak immune system
have TB or have been in close contact with someone with TB
have had shingles (herpes zoster)
have had hepatitis B or hepatitis C
live, have lived, or traveled to certain parts of the country (such as the Ohio & Mississippi River Valleys and the Southwest) where there is an increased chance for getting certain kinds of fungal infections. These infections may happen or worsen when taking LITFULO. Ask your healthcare provider if you’re unsure if you have lived in an area where these infections are common.
have had any type of cancer
have had blood clots
are a current or past smoker
have had a heart attack, other heart problems, or stroke
have liver problems
have low platelet counts or white blood cell counts
have recently received or are scheduled to receive any vaccinations. People who take LITFULO should not receive live vaccines right before or during treatment.
are pregnant or plan to become pregnant. It is not known if LITFULO will harm your unborn baby. Tell your healthcare provider if you are pregnant or plan to become pregnant during treatment with LITFULO. There is a pregnancy registry for people who take LITFULO during pregnancy. Report pregnancies to Pfizer Inc. at 1-877-390-2940.
are breastfeeding or plan to breastfeed. It is not known if LITFULO passes into your breast milk. Do not breastfeed during treatment with LITFULO and for 14 hours after your last dose of LITFULO. Talk to your healthcare provider about the best way to feed your baby during treatment with LITFULO.

Tell your healthcare provider about all the medicines you take, including prescription and over‑the‑counter medicines, vitamins, and herbal supplements. LITFULO and other medicines may affect each other causing side effects.

The most common side effects of LITFULO include headache; diarrhea; acne; rash; hives; inflamed hair pores (folliculitis); fever; eczema; dizziness; shingles; decreased red blood cell counts; and mouth sores, redness and swelling of the lining of your mouth. These are not all of the possible side effects of LITFULO.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or by visiting www.fda.gov/MedWatch. You may also report side effects to Pfizer at 1-800-438-1985.

What is LITFULO?

LITFULO (ritlecitinib) is a prescription medicine used to treat severe alopecia areata in adults and adolescents 12 years and older.

It is not known if LITFULO is safe and effective in children under 12 years of age.

Please see full Prescribing Information, including BOXED WARNING, and Medication Guide.

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Marygrace Taylor is a health and wellness writer for Prevention, Parade, Women’s Health, Redbook, and others. She’s also the co-author of Prevention’s Eat Clean, Stay Lean: The Diet and Prevention’s Mediterranean Kitchen. Visit her at marygracetaylor.com.