A Clinician’s Guide to Pediatric and Adolescent Alopecia Areata Treatments

September 2024 in “ JAAD reviews. ”

Heli A. Patel, Rishab Revankar, Jenna E. Koblinski, Benjamin Ungar, Emma Guttman‐Yassky, Jamie MacKelfresh, Dirk M. Elston, Peter Lio

alopecia areata topical corticosteroids minoxidil intralesional corticosteroids JAK inhibitors dupilumab systemic corticosteroids phototherapy Rogaine

From the encyclopedia

Alopecia Areata →

autoimmune disorder causing patchy hair loss

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Studysummary This article outlines treatment options and counseling recommendations for pediatric alopecia areata, highlighting shared decision-making based on disease severity and patient goals, with newer treatments like JAK inhibitors and dupilumab requiring attention to cost and side effects.

Automatically generated from the study's abstract, not written by a person, and not a review of the full paper. Not medical advice or a treatment recommendation. Read the original study, and consult a qualified healthcare professional before changing treatment. Full disclaimer

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Research cited in this study

38 / 38 results

research Review of Superficial Cryotherapy for the Treatment of Alopecia Areata

6 citations , July 2023 in “Journal of Drugs in Dermatology”

This narrative review found that cryotherapy resulted in approximately 60% hair regrowth response in alopecia areata patients, with some evidence suggesting lower relapse rates compared to intralesional steroid injection, although no statistically significant difference in efficacy was identified.

research Efficacy and Safety of Ritlecitinib in Adults and Adolescents With Alopecia Areata: A Randomised, Double-Blind, Multicentre, Phase 2b–3 Trial

227 citations , April 2023 in “The Lancet”

Ritlecitinib effectively treats alopecia areata and is well-tolerated.

research Guidelines for the Management of Patients with Alopecia Areata in Korea: Part II Systemic Treatment

10 citations , January 2023 in “Annals of Dermatology”

This study produced updated treatment guidelines for severe alopecia areata patients in Korea, highlighting the efficacy of systemic corticosteroids, oral cyclosporine, and Janus kinase inhibitors.

research Shared Decision-Making, Therapeutic Choice, and Decisional Regret in Patients With Alopecia Areata

23 citations , August 2022 in “JAMA Dermatology”

In this study, patients with alopecia areata indicated a preference for shared decision-making (SDM) with their dermatologists, and those who engaged in SDM reported less decisional regret about their treatment choices.

research Oral Tofacitinib for the Treatment of Alopecia Areata in Pediatric Patients

13 citations , November 2021 in “Pediatric Dermatology”

This study found that oral tofacitinib was effective and well tolerated for treating alopecia areata in most pediatric patients, with nearly 73% experiencing hair regrowth.

research A Systematic Review on the Treatment of Pediatric Severe Alopecia Areata by Topical Immunotherapy, Anthralin, or Low-Level Light/Laser Therapy: Focus on Efficacy, Safety, Treatment Duration, Recurrence, and Follow-Up Based on Clinical Studies

17 citations , October 2021 in “Journal of Cosmetic Dermatology”

This review found that topical immunotherapy and light/laser therapy may achieve over 50% hair regrowth efficacy in treating extensive alopecia areata in children, with no serious side effects observed.

research Treatment of Pediatric Alopecia Areata: A Systematic Review

48 citations , April 2021 in “Journal of the American Academy of Dermatology”

This study found that topical corticosteroids are the most supported first-line treatment for pediatric alopecia areata, with contact immunotherapy as the next best option.

research Dupilumab Therapy for Alopecia Areata in Pediatric Patients with Concomitant Atopic Dermatitis

19 citations , January 2021 in “Journal of the American Academy of Dermatology”

This study reported that some pediatric patients with alopecia areata experienced hair regrowth with dupilumab treatment, particularly those with concomitant atopic dermatitis, suggesting dupilumab may be beneficial when traditional therapies fail.

research Italian Guidelines in Diagnosis and Treatment of Alopecia Areata

37 citations , December 2019 in “Giornale italiano di dermatologia e venereologia”

This Italian guideline discusses the diagnosis and treatment of alopecia areata but reports no new clinical trial results; the authors highlight the need for well-designed studies.

research Combination Tofacitinib and Oral Minoxidil Treatment for Severe Alopecia Areata

23 citations , September 2019 in “Journal of The American Academy of Dermatology”

In this retrospective analysis, combination therapy with tofacitinib and oral minoxidil led to significant scalp hair regrowth in patients with severe alopecia areata, with 67% achieving at least 75% regrowth, although the small sample size limits the findings.

research Response to Tofacitinib Therapy of Eyebrows and Eyelashes in Alopecia Areata

11 citations , November 2018 in “Journal of the American Academy of Dermatology”

This study found that among patients with alopecia areata treated with the JAK inhibitor tofacitinib, 34% achieved complete regrowth of eyebrows and 39% achieved complete regrowth of eyelashes, highlighting differences in treatment responses across hair-bearing sites.

research Response to Ustekinumab in Three Pediatric Patients with Alopecia Areata

25 citations , October 2018 in “Pediatric dermatology”

In this study, three pediatric patients with alopecia areata demonstrated hair regrowth after being treated with ustekinumab.

research Recalcitrant Alopecia Areata Responsive to Leflunomide and Anthralin—Potentially Undiscovered JAK/STAT Inhibitors?

11 citations , October 2018 in “Pediatric dermatology”

In this case report, the authors describe a child with treatment-resistant alopecia areata who successfully responded to leflunomide and anthralin, proposing this combination as a potentially cost-effective alternative for managing recalcitrant cases by possibly inhibiting the JAK/STAT pathway.

research Topical 2% Tofacitinib for Children with Alopecia Areata, Alopecia Totalis, and Alopecia Universalis

49 citations , May 2018 in “Journal of the American Academy of Dermatology”

This letter discusses the limited treatment options for pediatric alopecia areata and the lack of controlled studies for therapies like systemic and off-label immunosuppressive drugs, without reporting new clinical results.

research Alopecia Areata Treated With Hydroxychloroquine: A Retrospective Study of Nine Pediatric Cases

17 citations , March 2018 in “Pediatric dermatology”

This study suggests that hydroxychloroquine may benefit some children with alopecia areata, as five out of nine patients showed improvement, although side effects like gastrointestinal intolerance and headache were noted.

research Efficacy of Intralesional Triamcinolone Acetonide in Alopecia Areata by Dermojet at Abbasi Shaheed Hospital, Karachi, Pakistan

3 citations , January 2018 in “Rawal Medical Journal”

This study at Abbasi Shaheed Hospital reported that intralesional triamcinolone acetonide via Dermojet was highly effective, with 75 out of 100 alopecia areata patients showing significant hair regrowth in affected patches.

research Role of Hair Prostheses (Wigs) in Patients with Severe Alopecia Areata

15 citations , January 2018 in “Annals of Dermatology”

Wigs significantly improve the well-being of people with severe hair loss.

research Tofacitinib 2% Ointment, a Topical Janus Kinase Inhibitor, for the Treatment of Alopecia Areata: A Pilot Study of 10 Patients

48 citations , November 2017 in “Journal of the American Academy of Dermatology”

Tofacitinib 2% ointment helped hair regrow in 3 out of 10 patients with alopecia areata, but caused side effects like scalp irritation and raised cholesterol in some.

research Topical Janus Kinase Inhibitors for the Treatment of Pediatric Alopecia Areata

83 citations , June 2017 in “Journal of the American Academy of Dermatology”

This study observed that most pediatric patients with alopecia areata experienced some hair regrowth after treatment with topical JAK inhibitors, and the formulations were generally well-tolerated with mild lab abnormalities in some cases.

research Bilateral Half-Head Comparison of 1% Anthralin Ointment in Children with Alopecia Areata

24 citations , January 2017 in “Pediatric dermatology”

This study found that 1% anthralin ointment effectively promoted hair growth in children with chronic, severe alopecia areata, showing complete or partial responses in 70% of participants over 12 months, without serious adverse events.

research A Systematic Review of Pulse Steroid Therapy for Alopecia Areata

50 citations , January 2016 in “Journal of the American Academy of Dermatology”

This systematic review of pulse corticosteroid therapy for alopecia areata found relatively low complete response rates, but responders experienced low relapse rates, indicating potential benefits for patients with favorable prognostic factors.

research Efficacy and Safety of Methotrexate Combined with Low- to Moderate-Dose Corticosteroids for Severe Alopecia Areata

28 citations , January 2016 in “Dermatology”

This study observed that methotrexate combined with low- to moderate-dose oral corticosteroids may effectively treat severe alopecia areata, though long-term maintenance is often necessary due to relapse after tapering.

research Reversal of Alopecia Areata Following Treatment With the JAK1/2 Inhibitor Baricitinib

184 citations , February 2015 in “EBioMedicine”

This study observed that baricitinib treatment led to significant improvement in a patient's alopecia areata symptoms and suggests further clinical trials to explore its potential as a treatment.

research Alopecia Areata: An Evidence-Based Treatment Update

72 citations , July 2014 in “American journal of clinical dermatology”

This review analyzed randomized controlled trials on alopecia areata treatment and found that while several treatments showed effectiveness, most studies had limitations affecting their interpretability.

research Clinical Response to Combined Therapy of Cyclosporine and Prednisone

10 citations , December 2013 in “The journal of investigative dermatology. Symposium proceedings/The Journal of investigative dermatology symposium proceedings”

This case report describes a patient with severe alopecia areata and multiple autoimmune diseases who showed excellent hair regrowth after treatment with prednisone and cyclosporine, though she later developed hyperpigmentation.

research Clobetasol Propionate, 0.05%, vs Hydrocortisone, 1%, for Alopecia Areata in Children

49 citations , November 2013 in “JAMA dermatology”

This study found that topical clobetasol propionate cream was more effective than hydrocortisone cream in reducing hair loss surface area in children with patchy alopecia areata over 24 weeks, with no serious adverse effects.

research Hair and Scalp Dermatoscopy

245 citations , March 2012 in “Journal of The American Academy of Dermatology”

This review discusses the dermoscopic features of common hair and scalp disorders and reports no new clinical results, aiming to assist dermatologists in diagnosing conditions like tinea capitis and alopecia areata.

research Topical Immunotherapy in Alopecia Areata

45 citations , January 2010 in “International journal of trichology”

This review examines topical immunotherapy for severe alopecia areata, noting that diphencyprone and squaric acid dibutylester are non-mutagenic options with similar efficacy but different practical considerations, and reports no new clinical results.

research Treatment of Severe Alopecia Areata with Intralesional Steroid Injections

60 citations , October 2009 in “PubMed”

This study reports that intralesional triamcinolone acetonide was effective and well-tolerated for treating extensive alopecia areata in patients who often showed specific initial hair characteristics.

research 308-nm Excimer Laser for the Treatment of Alopecia Areata in Children

79 citations , September 2009 in “Pediatric dermatology”

This study found that the 308-nm Excimer laser was effective and safe for treating patchy alopecia areata in children, with hair regrowth observed in 60% of treated scalp patches.

research Phototherapy in Childhood Dermatoses

65 citations , November 2008 in “Pediatric Dermatology”

This study observed that phototherapy is an effective and well-tolerated treatment for childhood dermatoses, particularly for psoriasis and pityriasis lichenoides chronica.

research Infant Alopecia Universalis: Role of Topical PUVA (Psoralen Ultraviolet A) Radiation

4 citations , July 2005 in “International Journal of Dermatology”

This article does not contain an abstract and presents no new clinical findings, instead discussing prior cases and literature on infant alopecia universalis and the potential role of topical PUVA therapy.

research Clobetasol Propionate 0.05% Under Occlusion in the Treatment of Alopecia Totalis/Universalis

146 citations , July 2003 in “Journal of the American Academy of Dermatology”

In this study, clobetasol propionate 0.05% ointment was found to induce hair regrowth in 28.5% of patients with severe alopecia areata under occlusive conditions, though long-term benefit was limited to 17.8%.

research The Pattern and Profile of Alopecia Areata in Singapore: A Study of 219 Asians

275 citations , November 2002 in “International Journal of Dermatology”

This study found that among an Asian population with alopecia areata, commonly first episodes occurred before age 40, with severe cases linked to psychological effects and treatments showing significant regrowth.

research Topical Minoxidil Solution (1% and 5%) in the Treatment of Alopecia Areata

101 citations , March 1987 in “Journal of The American Academy of Dermatology”

Minoxidil solution helps hair regrowth in alopecia areata, with 5% being more effective.

research Double-Blind, Placebo-Controlled Evaluation of Topical Minoxidil in Extensive Alopecia Areata

104 citations , March 1987 in “Journal of The American Academy of Dermatology”

Minoxidil helps hair growth in 63.6% of alopecia patients, with 27.3% having excellent results.

research Topical Photochemotherapy for Alopecia Areata

63 citations , April 1985 in “Journal of the American Academy of Dermatology”

This study observed that topical PUVA treatment led to excellent or good hair regrowth in 45.4% of patients with alopecia areata, though many experienced relapse after treatment stopped.

research Photochemotherapy and Alopecia Areata

10 citations , May 1983 in “International Journal of Dermatology”

This study found that four out of ten patients with alopecia areata experienced some hair regrowth after PUVA therapy, though this treatment should be reserved for those unresponsive to other options due to potential long-term side effects.