35M with alopecia areata - Treatments failing, next steps?

I’ve been losing hair since I was 17. I’m 35 now and currently around Norwood 2.5 to Norwood 3.

I keep losing hair and can’t seem to stop the progression.

I was on finasteride 1.25 mg from 2015 to 2025. I also used topical minoxidil on and off from 2015 to 2024.

Neither seemed to work. In 2024, I was prescribed oral minoxidil 2.5 mg and continued with 1.25 mg finasteride after my doctor suggested I take a few months off. As far as I could tell, I didn’t see any improvement.

Since January 2025, I’ve been taking 0.5 mg dutasteride daily and 5 mg oral minoxidil. So far, it hasn’t made much of a difference. I’m still thinning and receding.

I’m starting to wonder if this is actually male pattern baldness.

Over the last couple of years, I’ve dealt with significant stress, severe eczema, and alopecia areata. I was never able to grow a full beard, but the alopecia areata turned what I had into “Swiss cheese.” After steroid injections, the beard hair started growing back.

Recently, I’ve noticed small patches/holes appearing in my beard again. I’ve also noticed thinning on the right side of my scalp, especially near the ear.

My dermatologist wants to put me on JAK inhibitors, but they’re extremely expensive and I can’t afford them.

What are my options? Is it possible this was never male pattern baldness and something else is going on?

It’s your hair loss is probably related to alopecia areata over mpb, given the patchy nature and regrowth after steroids. Managing stress and eczema could also play a role in your hair health. JAK inhibitors are indeed promising for alopecia areata but are costly. You might want to explore topical treatments for eczema and consider CBD oil with MCT for scalp health. These could potentially help reduce inflammation and stabilize your condition. Keep monitoring and adjust based on what you see.

See areata in research, there might be something interesting here for you: