Efficacy, Safety, and Pharmacoeconomics of Three Common Strategies for Pediatric Alopecia Areata Patients: A Retrospective Cohort Study

In a retrospective cohort study of 24 pediatric patients with alopecia areata (AA), three treatment strategies were evaluated for efficacy, safety, and pharmacoeconomics. The traditional treatment group had a 100% (12/12) success rate in achieving complete hair regrowth (SALT100), while in the tofacitinib group, 40% (2/5) reached at least 50% hair regrowth (SALT50), and another 40% (2/5) achieved complete regrowth (SALT100). In the microneedling (MN) group, 42.86% (3/7) were non-responders, but another 42.86% (3/7) achieved complete regrowth (SALT100). All treatments had mild adverse effects, with no treatment discontinuations due to these effects. The study concluded that traditional treatment should be the first-line approach for newly diagnosed or treatment-naive pediatric AA patients, while tofacitinib and microneedling could be considered for severe, long-duration, or refractory cases, with the caveat that MN is more time-intensive and expensive.