A consensus-based treatment algorithm for alopecia areata in adolescents and adults: integrating severity, quality of life, and disease dynamics.

INTRODUCTION

Alopecia areata (AA) is an autoimmune, inflammatory condition characterized by non-scarring hair loss on the scalp, face, or body. It can significantly affect a person's quality of life (QoL) and mental health.

METHODS

Using a modified Delphi method, a panel of expert dermatologists developed a practical treatment algorithm to help clinicians deliver personalized, safe care to diverse patients with AA.

RESULTS

The approach to the algorithm introduces a broader definition of disease severity, incorporating not only Severity of Alopecia Tool (SALT) scores but also quality-of-life impact and the rate of disease progression.

DISCUSSION: Recent therapeutic advances have expanded access to effective, safe treatments for a broader population of AA patients. Ritlecitinib, a Janus kinase 3/TEC inhibitor, is currently the only oral Janus kinase inhibitor approved for adolescents and adults aged 12 years and older, whereas baricitinib, a Janus kinase1/2 inhibitor, is approved for adults aged 18 years and older. However, questions on the long-term safety of these therapies, access, and personalization still need to be addressed.

CONCLUSION

Future efforts should validate and refine the algorithm across real-world cohorts and ensure equitable access to personalized treatment for patients with AA.