TLDR TNF-α blockers and IL inhibitors improve symptoms in most patients with severe scalp condition, but more research is needed.
This systematic review analyzed 34 articles involving 81 patients to evaluate the safety and efficacy of TNF-α blockers, anti-interleukins, and small molecule inhibitors for treating dissecting cellulitis of the scalp (DCS), a challenging form of scarring alopecia. The review found that TNF-α blockers and IL inhibitors showed clinical improvement in most patients with moderate-to-severe DCS, especially those unresponsive to previous treatments. Certolizumab pegol was noted as a potentially safe option during pregnancy. Small molecule inhibitors like JAK inhibitors and apremilast also demonstrated significant symptom improvement with a favorable safety profile. However, the data is limited, and further research is needed to confirm long-term safety and effectiveness, particularly regarding hair regrowth and scarring reversal.
February 2024 in “PloS one” Tofacitinib and adalimumab are promising treatments for cicatricial alopecia with few side effects.
1 citations
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January 2024 in “Curēus” Upadacitinib significantly improved a man's severe scalp condition when other treatments failed.
November 2023 in “Journal of Cosmetic Dermatology” Injecting a person's own fat into their scalp may help regrow hair and improve hair thickness in different types of hair loss.
1 citations
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September 2023 in “Dermatology and therapy” More research is needed to find the best treatment for dissecting cellulitis of the scalp.
2 citations
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March 2023 in “Frontiers in medicine” A 15-year-old boy's severe scalp condition improved significantly with adalimumab and baricitinib treatment.
20 citations
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March 2023 in “American Journal of Clinical Dermatology” Baricitinib improved severe hair loss in adults over 52 weeks and was safe to use.
January 2023 in “Dermatologic therapy” Dissecting Cellulitis of the Scalp is more common in young men and often associated with head and neck acne.
144 citations
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November 2020 in “Frontiers in immunology” Targeting the IL-23/IL-17 pathway effectively treats several inflammatory skin diseases.
159 citations
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October 2015 in “Science Advances” Blocking JAK-STAT signaling can lead to hair growth.
48 citations
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January 2014 in “Dermatology Online Journal” New treatments for Dissecting cellulitis show promise, but more research is needed to understand the disease and establish a standard treatment plan.
March 2026 in “Biomedicines” New treatments like biologics and JAK inhibitors show promise for severe scalp inflammation when traditional methods fail.
489 citations
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November 2021 in “Signal Transduction and Targeted Therapy” The JAK/STAT pathway is important in cell processes and disease, and JAK inhibitors are promising for treating related conditions.
January 2022 in “Dermatology Review” Higher IL-31 levels are linked to worse itching in chronic kidney disease patients.
60 citations
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September 2015 in “Expert Review of Clinical Immunology” Lymphocytes, especially CD8+ T cells, play a key role in causing alopecia areata, and targeting them may lead to new treatments.
September 2025 in “Frontiers in Immunology” Atopic dermatitis and alopecia areata share immune and genetic factors, and targeted therapies may help both.
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