Oral treatments tend to be reserved for the more extensive cases of alopecia areata, like Totalis (loss of all scalp hair) and Universalis (loss of scalp hair, eyebrows, eyelashes, and body hair).

First-line treatment for alopecia areata with extensive hair loss (including Alopecia Universalis and Totalis) is generally a JAK inhibitor.

In January 2024, Health Canada approved the JAK inhibitor baricitinib (Olumiant^®) for the treatment of severe alopecia areata in adults (50% hair loss or more). This is the first time Health Canada approved an oral drug as a treatment for alopecia areata. Baricitinib was first approved in 2018 to treat rheumatoid arthritis. Olumiant is an oral medication taken once daily.

In November 2023, Health Canada approved a JAK inhibitor ritlecitinib (Litfulo^®) for the treatment of severe alopecia areata in adults and adolescents ages 12 years and older. Litfulo is the first approved treatment for individuals under the age of 18. Litfulo is an oral medication taken once daily.

If you are interested in learning more about whether a JAK inhibitor is right for you, please speak with a dermatologist or healthcare professional who is experienced in the diagnosis and treatment of alopecia areata. If you do not have a dermatologist, try using the Find a Dermatologist tool to find practitioners in your area.