Improvement of Recalcitrant Folliculitis Decalvans With Tirzepatide: A Case Report

Folliculitis decalvans (FD) is a chronic inflammatory alopecia characterized by painful, scarring lesions and recurrent flares, often complicated by secondary bacterial infections. Despite the use of topical and systemic anti-inflammatory or antimicrobial therapies, FD remains challenging to manage, with limited therapeutic advancements. We report a case of recalcitrant FD in a man in his 40s who experienced significant symptom improvement and hair regrowth following the initiation of tirzepatide for weight management. This case highlights a previously unreported therapeutic benefit of tirzepatide in FD, potentially mediated through its anti-inflammatory and immunomodulatory effects. As glucagon-like peptide 1 (GLP-1) receptor agonists gain recognition for their efficacy in other inflammatory skin conditions, such as psoriasis and hidradenitis suppurativa, this case supports further exploration of their role in managing FD and other refractory dermatologic diseases.