Stopping JAK Inhibitors for Pregnancy: What Happens to Hair in AA? — Donovan Hair Clinic

BACKGROUND & PURPOSE
Janus kinase inhibitors (JAK inhibitors) can help severe alopecia areata (AA) regrow hair. But because safety in pregnancy isn’t fully known, and recommendations are now for women stop treatment when trying to conceive. This often leads to fear of hair loss returning. The purpose of this study was to describe what happens to scalp hair when JAK inhibitors are stopped for pregnancy — and what happens after restarting them postpartum.

METHODS
Doctors followed 9 women with severe AA through 14 pregnancies. All stopped oral JAK inhibitors before or early in pregnancy. Hair loss severity was measured using the SALT score before treatment, after stopping treatment, and after restarting postpartum.

RESULTS
Every woman experienced significant hair loss after stopping treatment. However, once JAK inhibitors were restarted — usually within 4 months after delivery — patients regrew their hair, often back to or better than before.

CONCLUSIONS
Women with AA who must stop JAK inhibitors during pregnancy should be counseled that hair shedding is highly likely. The encouraging news is that restarting treatment after delivery (and after breastfeeding is done) led to meaningful regrowth in all cases. This study highlights the emotional burden these women face and the need for clearer pregnancy-related treatment guidelines in AA.

REFERENCE
Ogbutor C, Chen L-C, Kalil LL, et al. Discontinuation and restart of Janus kinase inhibitors due to pregnancy in alopecia areata: a case series. Int J Womens Dermatol. 2025;11:e218.