Fleeing War and Finding Her Purpose
Natasha Mesinkovska’s path to dermatology was anything but conventional. Today, she is helping shape a breakthrough era in alopecia areata treatment.
October 2026
Natasha Mesinkovska, MD, PhD, is passionate about helping her patients grow hair and keep the hair they have. She is a bench scientist and clinical trialist whose relentless pursuit of better treatments for alopecia areata (AA) is central to her work caring for her patients. Mesinkovska is an associate professor and vice chair for clinical research in the Department of Dermatology, University of California, Irvine (UCI) School of Medicine.
“Alopecia areata was the reason I woke up for the better decade of my life,” she said. “We needed a medication for this disease, we needed clinical trials. Not many physician-scientists enter a field and get to witness the emergence of an effective medication to treat the disease that drew them there. I got to experience that.”
“Not many physician-scientists enter a field and get to witness the emergence of an effective medication to treat the disease that drew them there. I got to experience that.”
As part of her work to find treatments for AA, Mesinkovska became the chief science officer at the National Alopecia Areata Foundation (2015–2023), which promotes research into potential treatments and offers patient support and education. Her role there involved connecting physicians and scientists with pharmaceutical companies to trial experimental drugs. Since 2022, the FDA has approved two additional JAK inhibitors to treat AA, ritlecitinib, and deuruxolitinib, both of which Mesinkovska is a trialist (King et al. 2024a, 2024b; Sinclair et al. 2025).
Among the clinical trials she has been involved with, she was part of the team that trialed baricitinib, a JAK inhibitor and the first oral drug to be approved by the FDA to treat severe alopecia areata. The five-year data confirmed previous clinical trials that demonstrated the safety and efficacy of baricitinib to reverse hair loss (Vleugels et al. 2025).
The BRAVE-AA1 clinical trial found that 80% of patients who experienced hair regrowth relapsed at 152 weeks following cessation of baricitinib (King et al. 2024). The hope is to discover why 20% keep their regrown hair and develop tests to select them. There is already a blood test for the newest drug, deuruxolitinib, to identify mutations that will make a patient prone to not properly metabolizing the medication, thus putting them at greater risk for side effects.
“It’s reassuring that we’re not going to prescribe long-term medication if someone is unsuitable for treatment,” Mesinkovska said. “I’m excited about being able to figure out the right population to treat.”
Despite her success as a clinician — she is beloved by the patients she sees four days a week — Mesinkovska’s path to dermatology and clinical trials began in the research lab.
“I’m a bench scientist who is now a clinician and a trialist. I can defend myself when a scientist talks about something like phosphorylation studies in mice because I’m a bench scientist. I see the need for bench work but we in the clinic need to move quicker.”
“I’m a bench scientist who is now a clinician and a trialist,” she said. She noted that, while mouse models of hair loss can direct future research, it is trialists like her who need to design safe human studies. “Clinical scientists often get dismissed in the world of dermatology research, but I can defend myself when a scientist talks about something like phosphorylation studies in mice because I’m a bench scientist. I see the need for bench work but we in the clinic need to move quicker. We need medications for our patients now.”
Crossing political and social borders
Mesinkovska was born in the south of the former Yugoslavia in what is now Macedonia. She was 15 when the Balkans war erupted and borders closed.
“This shouldn’t have been happening in what is supposed to be your happy part of life,” she said. “Our house was full of Bosnian women refugees who told my parents that the soldiers coming had been pillaging and raping. My parents gathered whatever money we had and a bunch of us left as exchange students.”
She left her home just before her 16th birthday, marking the last time she lived with her parents. Mesinkovska moved to the US where she lived in a series of makeshift housing situations, sometimes with exchange families, sometimes homeless. She always had two or three jobs to make ends meet, worked diligently to improve her English, and studied hard so she could win full scholarships.
Mesinkovska completed her BSc at East Stroudsburg University (ESU) in Pennsylvania where she received a full scholarship that included a stipend for a meal each weekday. She applied and was accepted at the Georgetown University School of Medicine. But she was living alone far from the family she had left behind, had $400 in her bank account, and wasn’t eligible for financial aid to cover tuition. So she pivoted and applied instead to a doctoral program in cancer biology at Wayne State University in Detroit.
In Detroit, she worked at various jobs to help pay her way through graduate school. Once she got her PhD, with publications and a Young Investigator Award from the Susan G. Komen Breast Cancer Foundation in her pocket, she reapplied to medical schools, including the Mayo Clinic College of Medicine where she received a full scholarship in 2003.
Moving to Rochester
She moved for medical school from Detroit, where she had finally come into her own and was actively involved in the local nightlife and dance scene.
“At Mayo, I got the best education, had amazing mentors, and trained at a place where everything centers on the patient,” she said. “That place taught me everything I know.”
But she struggled in Rochester, a small town where people seemed to expect her to look and behave a certain way. “I got comments that I needed to curb my urban down. I felt like I couldn’t fit into the mold.”
When it came time for her dermatology residency, Mesinkovska wanted another big city and chose the Cleveland Clinic, where she stayed on as a dermatopathologist until 2014. She received an Excellence in Medical Education Award from the Cleveland Clinic, as well as numerous accolades related to her passion for education and patient care from the Cleveland City Council.
She was recruited in 2015 to UC Irvine by Christopher Zachary, one of the earliest Mohs surgeons and a laser pioneer. She was made director of integrative dermatology at the Beckman Laser Institute, where she performs cosmetic procedures to vet the machines and lasers that get approved.
“I came wanting to regrow hair with lasers and look into skin and nerve regeneration,” she said. Early studies showed positive results, which she spent two years trying to repeat. “You can get some hair growth, but it’s not permanent.”
In the past few years, she has also been involved in cosmetics where her data mind and newly acquired learning of invasive and non-invasive modalities allow her to objectively measure widespread popular treatments and machines that are being used in cosmetic dermatology.
Patient-centered research initiatives
- Mesinkovska pursues a wide range of research topics, all driven by the common goal of wanting to improve the lives of her patients. Many of these ideas arise from conversations she has with her patients or with the residents she mentors.
- When her patients wanted to know if oral collagen supplements were useful for skin ailments, she undertook a systematic review of 11 studies with two of her students (Choi et al. 2019). The study concluded that the evidence was promising for wound healing and skin aging but required further research.
- Another resident wondered if oral minoxidil, used to treat hair loss, could adversely affect cancer, since it is a blood pressure medicine. This is relevant since about 20% of her patients have chemotherapy-induced alopecia. Results demonstrated that oral minoxidil does not have an association with increased risk of malignancy. (Woll et al. 2026).
- Intrigued by Korean data showing a survival benefit for those with vitiligo (Ju et al. 2024), she published data collected from the TriNetX Network database of patients with AA showing similar comorbidity benefit (Birda et al. 2024). She felt the benefit was too high — “too good to be true,” in her words — but that it pointed to potential further research.
Dupilumab and the treatment of pediatric AA
Mesinkovska is driven to find and test new treatments for her patients. Dupilumab is an IL-4 and IL-13 receptor antagonist used to treat atopic dermatitis (AD), asthma, and other diseases. Mesinkovska is part of a clinical trial testing whether higher doses of dupilumab can also treat pediatric AA (NIH 2025).
She and her colleagues have found that dupilumab has confounding data when used to treat AD, with some patients on the biologic developing AA while others experience hair regrowth (Marks et al. 2023). Those with hair regrowth were mostly female with concomitant AD. This may suggest involvement of the Th2 (type 2 T-helper cells) pathway in some patients. Given the small patient cohort, Mesinkovska noted the need for further research to compare sex, duration of AD, and the presence of other atopic comorbidities to determine which patients are most likely to benefit from dupilumab treatment and which may develop AA during therapy.
Natasha Mesinkovska’s journey from a teenage refugee of war-torn Yugoslavia to a physician-scientist making significant contributions to the treatment of alopecia areata is a rare combination of resilience, curiosity, and compassion. Her ability to translate complex research into tangible benefits for her patients is driven by a desire, not only to regrow hair, but to improve lives.
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References
Birda A, Choe S, Salas J, et al. Alopecia areata: Mortality trends from a population-based cohort study reflect increased survival. J Am Acad Dermatol. 2025;92(3):558–559.
Choi FD, Sung CT, Juhasz ML, et al. Oral Collagen Supplementation: A Systematic Review of Dermatological Applications. J Drugs Dermatol. 2019;18(1):9–16.
Ju HJ, Lee SE, Lee SH, et al. All-cause and cause-specific mortality among patients with vitiligo: a nationwide population-based study in Korea. J Invest Dermatol. 2024;125(1):125–132.e3.
King B, Ko J, Kwon O, Vañó-Galván S, et al. Baricitinib Withdrawal and Retreatment in Patients With Severe Alopecia Areata: The BRAVE-AA1 Randomized Clinical Trial. JAMA Dermatol. 2024a;160(10):1075–1081.
King B, Senna MM, Mesinkovska NA, et al. Efficacy and safety of deuruxolitinib, an oral selective Janus kinase inhibitor, in adults with alopecia areata: Results from the Phase 3 randomized, controlled trial (THRIVE-AA1). J Am Acad Dermatol. 2024b;91(5):880–888.
Marks DH, Mesinkovska N, Senna MM. Cause or cure? Review of dupilumab and alopecia areata. J Am Acad Dermatol. 2023 Mar;88(3):651–653.
NIH. National Library of Medicine. ClinicalTrials.gov. Dupilumab in the Treatment of Pediatric Alopecia Areata. Accessed 29 December 2025.
Nohria A, Desai D, Klein EJ, et al. The overturn of Roe v Wade: Google searches for teratogenic medications following the U.S. Supreme Court ruling. Int J Womens Dermatol. 2024;10(2):e139.
Sinclair R, Mesinkovska N, Mitra D, et al. Patient-Reported Hair Loss and Its Impacts as Measured by the Alopecia Areata Patient Priority Outcomes Instrument in Patients Treated with Ritlecitinib: The ALLEGRO Phase 2b/3 Randomized Clinical Trial. Am J Clin Dermatol. 2025;26(1):109–119.
Vleugels RA, Piraccini BM, Mesinkovska N, et al. 2025. Baricitinib Provides Sustained, Long-Term Efficacy With Consistent Safety for Up to 5 Years of Treatment in Adults With Severe Alopecia Areata: Final Results From BRAVE-AA1 and BRAVE-AA2. Skin J Cutan Med. 2025;9(6):November 2025 issue.
Woll JP, Mesinkovska N, et al. Minoxidil use and malignancy risk across organ systems: A retrospective cohort study with TriNetX. J Am Acad Dermatology. 2026 May;94(5):1527-1529.