Hair today, bald recently

In eight months, a young man from Connecticut went from completely bald to thickly thatched, thanks to a breakthrough treatment by a Yale dermatologist.

Brett King ’05MD, assistant professor of dermatology at the School of Medicine, had seen research demonstrating that a rheumatoid arthritis drug called tofacitinib citrate could reverse alopecia areata, a form of hair loss, in mice. The drug also had been used to treat psoriasis in human beings.

So when a patient came to King with both psoriasis and alopecia universalis—which causes total hair loss on the head, face, and body—he decided to try tofacitinib pills for both conditions.

The results, King says in a Yale News release, were “exactly what we hoped for”: after eight months, the 25-year-old patient had regrown all his hair—including eyebrows, lashes, and body hair—with no ill effects. The drug was “mildly effective” for his psoriasis.

Alopecia universalis, alopecia areata, and a third type of hair loss called alopecia totalis are all autoimmune disorders, as are psoriasis and rheumatoid arthritis are also autoimmune diseases. King believes that tofacitinib turned off the immune system’s attack on his patient’s hair follicles, allowing for regrowth.

And he believes it will work for alopecia areata and alopecia totalis as well. For his next study, he plans to try a tofacitinib cream on patients with alopecia areata.

He probably won’t have trouble finding volunteers. After the news hit the headlines, King has been flooded with messages from people suffering from the diseases, which affect millions nationally.

“It’s mind-boggling the number of folks out there who are truly despairing,” King says in a phone interview. “The truly exciting part is the amazing amount of hope that has been created or renewed.”

“It is reasonable for folks to comment, ‘well, it is one patient,’" continues King—who, in his Yale faculty photo, appears to own a full head of hair. “But this was not an accidental finding. I connected the dots between the medical science research” and a medication whose mechanism “is fairly well elaborated.”

That doesn’t necessarily mean his discovery will help people with the far more common types of hair loss known as male pattern and female pattern baldness.

“It would be wrong to say that this medicine will work for those conditions,” King says. “Nobody should run out and try to get their hands on tofacitinib because they’ve lost three inches of hairline. No, no, no, no, no.”

“However.”

King pauses for emphasis. “However. In one day, we’ve taken an enormous step forward. A year ago, there was nothing for these millions of people, and now there is. So why wouldn’t we try to do simple things that we felt were safe to take the lessons that we’ve learned here and see if we’ve learned something about more common hair loss?”

He acknowledges that he’s not thinking of a specific biological mechanism or line of scientific inquiry. Rather, it’s a belief that one breakthrough could lead to another: “I’m just an optimist.”

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The Yale Alumni Magazine is published by Yale Alumni Publications Inc., an alumni-based nonprofit that is not run by Yale University. Its content does not necessarily reflect the views of the university administration.