Expert Consensus on Systemic Treatment Activation and Grading Evaluation for Alopecia Areata

    December 2025 in “ Chinese Medical Journal
    Cheng Zhou, Xufeng Du, Weixin Fan, Hong Fang, Yiqun Jiang, Ji Li, Ying Luo, Zhongfa Lyu, Longquan Pi, Yongjun Piao, Yan Ru Tan, X F Wang, Aihua Wei, Jinjin Wu, Xuegang Xu, Dingquan Yang, Qinping Yang, Shuxia Yang, Xingqi Zhang, Hengguang Zhao, Fenglin Zhuo, Xiangqian Li, Wenyu Wu, Jianzhong Zhang, Chinese Society of Dermatology; on behalf of Working group for hair diseases, Chinese Association of Rehabilitation Dermatology; Working group for hair diseases
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    Studysummary This study developed a simplified multidimensional assessment scale for alopecia areata severity and systemic treatment initiation among Chinese patients, achieving expert consensus on relevant clinical indicators and conditions.
    Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer
    The expert consensus on systemic treatment activation and grading evaluation for alopecia areata (AA) in China aims to standardize assessment and management practices. Developed with input from 23 senior dermatology experts using the Delphi method, the consensus introduces a framework with 7 severity grading items and 6 systemic treatment initiation criteria. Key recommendations include using the Severity of Alopecia Tool (SALT) to classify AA severity, with systemic treatment advised for severe cases (SALT ≥50) or specific subtypes like ophiasis and diffuse AA. The consensus highlights the importance of patient self-reported outcomes and personalized treatment decisions. A simplified multidimensional assessment scale was developed, recommending systemic treatment for SALT scores ≥50 or between 20 and 50 if additional criteria are met, such as a positive hair-pull test or psychosocial impairment. This approach supports personalized care and contributes to global AA research.
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