Besides cost considerations, a hair transplant is generally prescribed as a last resort for permanent hair loss problems. It is also not allowed for people under the age of 25, those with a continuing problem of hair loss, as well as those with other health conditions like uncontrolled diabetes, serious heart problems and hypertension. Patients whose hair loss is caused by other factors, such as a skin or scalp disorder or who suffer from a psychological condition that causes them to pull at their hair are not recommended for this procedure. Since the procedure requires taking a sample from the back of the head, those who do not have enough follicles from this section that can be used for transplant are not also eligible.
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Dupilumab is FDA approved for treating eczema aka atopic dermatitis and sold under the brand name Dupixent.  As the story goes, a patient with alopecia totalis (a form of areata which leaves a person’s head completely bald) was being treated for eczema by the drug Dupixent. After 6 weeks the patient first began to notice progress in terms of hair growth and at 7 months she had noticeable pigmented hair growth on her scalp. Notably, the patient stopped taking the dupilumab for a period of time and noticed her growth subsided; when she began taking the drug again the hair improved once more. This provides another useful therapy option for patients seeking treatment for AA. One would imagine a topical version would be worthwhile to investigate.
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