Aims: To demonstrate the effectiveness and safety of oral tofacitinib in treating severe alopecia areata.

Methods: We present a case series of four patients with severe alopecia areata treated with oral tofacitinib (Xeljanz) on compassionate supply from Pfizer.

Results: Workup, monitoring and side effects are discussed. All patients have had a complete clinical response while remaining on therapy with regrowth of hair on scalp, face and body. One patient had comorbid vitiligo which also responded. All patients remain on tofacitinib to prevent relapses.

Conclusions: The JAK inhibitors have an increasing role in dermatology. In this case series we present four patients with significant response to treatment without concerning side effects.