Treatment of Steroid-Resistant Beard-Restricted Alopecia Areata with Baricitinib

Alopecia areata is an autoimmune disorder causing localized hair loss due to T-cell attack on hair follicles. Beard involvement holds psychological and cultural significance, and treatment guidance for steroid-resistant cases is limited. We present a case of the successful treatment of steroid-resistant beard alopecia areata (BAA) with baricitinib, a JAK-1/2 inhibitor, in a 37-year-old male. Prior therapies, including topical ruxolitinib and intralesional steroids, had failed. Over 9 months, baricitinib (4 mg daily) and oral minoxidil led to reduced alopecic patches, increased hair density, and resolved inflammation. This case underscores the potential of JAK inhibitors for BAA, emphasizing the importance of establishing clear guidelines to direct treatment of in order to optimize patient outcomes.