Clinical Guidelines of Ukrainian Hair Research Society: Diagnosis and Treatment of Alopecia Areata

November 2023 in “ Aktualʹnì problemi sučasnoï medicini ”

Inessa Mykhailivna Serbina, Kuzma Кhobzei, Тетяна Лядова, Oleksandr I. Litus, С. В. Возіанова, Yu.V. Andrashko, Svitlana Halnykina, T.V. Svyatenko, Igor Svistunov, Оrysya Syzon, Iryna Kadyhrob, Yuliya Ovcharenko

alopecia areata antidepressants oral cyclosporine intralesional steroid injections triamcinolone acetonide immune privilege collapse genetic aspects micronutrients methotrexate serum iron ferritin levels minoxidil ritlecitinib baricitinib hair prostheses Janus Kinase inhibitors Rogaine JAK inhibitors

From the encyclopedia

Alopecia Areata →

autoimmune disorder causing patchy hair loss

Triamcinolone Acetonide →

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Studysummary This article provides a review of alopecia areata, highlighting the development of diagnostic and therapeutic algorithms that consider factors such as age, disease severity, and quality of life, but it reports no new clinical findings.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The document provides clinical guidelines for diagnosing and treating alopecia areata, discussing the role of psychological disorders, the burden of the disease, and current unmet needs. It highlights the use of antidepressants, oral cyclosporine, intralesional steroid injections, and different concentrations of intralesional triamcinolone acetonide in treatment. The role of immune privilege collapse and genetic aspects of the condition are also discussed. Comorbidities and the role of micronutrients in patients with alopecia areata are covered, along with the use of methotrexate, serum iron and ferritin levels, and minoxidil. The efficacy and safety of ritlecitinib and baricitinib in treatment are discussed, as well as the use of hair prostheses in severe cases. The safety of Janus Kinase inhibitors in patients with alopecia areata is also mentioned.

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Research cited in this study

38 / 38 results

research Safety of Janus Kinase Inhibitors in Patients with Alopecia Areata: A Systematic Review

3 citations , May 2023 in “Clinical drug investigation”

This study reviewed the safety of JAK inhibitors for alopecia areata, finding that common side effects included headache and acne, with varying risks for respiratory infections and no increased risk of serious adverse events.

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 Alopecia Areata: Burden of Disease, Approach to Treatment, and Current Unmet Needs

1 citations , March 2023 in “Clinical, Cosmetic and Investigational Dermatology”

This review discusses recent advances in understanding and treating alopecia areata, emphasizing the ongoing challenges and unmet needs in disease management; it reports no new clinical findings.

research Two Phase 3 Trials of Baricitinib for Alopecia Areata

148 citations , March 2022 in “The New England Journal of Medicine”

In two phase 3 trials, this study found that oral baricitinib significantly improved hair regrowth compared to placebo in adults with severe alopecia areata after 36 weeks, though longer trials are needed to ascertain its long-term efficacy and safety.

research Alopecia Areata: An Update on Etiopathogenesis, Diagnosis, and Management

290 citations , August 2021 in “Clinical Reviews in Allergy & Immunology”

JAK inhibitors show promise for treating alopecia areata, but more research is needed.

research The Epidemiology of Alopecia Areata: A Population-Based Cohort Study in UK Primary Care

117 citations , July 2021 in “British Journal of Dermatology”

This study reports that the incidence of alopecia areata is 0.26 per 1000 person-years in the UK, with higher rates among Asian ethnic groups, socially deprived populations, and urban residents.

research Joint Study of the Associations of HLA-B and the Transmembrane Short Tandem Repeat Polymorphism of MICA Protein with Alopecia Areata Shows Independent Associations of Both with the Disease

7 citations , February 2020 in “Clinical and Experimental Dermatology”

This study identified an association between alopecia areata and the MICA*009 and HLA-B14 genetic markers, highlighting the importance of studying them together to better understand their role in this condition.

research Cyclosporine for Moderate-to-Severe Alopecia Areata: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial of Efficacy and Safety

44 citations , April 2019 in “Journal of the American Academy of Dermatology”

This study observed that cyclosporine showed a trend toward improving alopecia areata symptoms compared to placebo, but the difference was not statistically significant.

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 Immune Privilege Collapse And Alopecia Development: Is Stress A Factor

51 citations , December 2017 in “Skin Appendage Disorders”

This review examines the literature on autoimmune hair loss disorders, highlighting the collapse of immune privilege and the potential role of neurogenic stress in this process, but reports no new clinical results.

research Alopecia Areata: A Comprehensive Review of Pathogenesis and Management

99 citations , July 2017 in “Clinical Reviews in Allergy & Immunology”

This review noted that alopecia areata is an autoimmune disease impacting hair follicles and offered insights into its complex pathogenesis involving immune responses, while highlighting ongoing research into new treatments such as Janus kinase inhibitors and other immunomodulatory drugs.

research Methotrexate for the Treatment of Pediatric Alopecia Areata

22 citations , June 2017 in “Journal of dermatological treatment”

This case series observed that 57% of pediatric patients with alopecia areata experienced significant hair regrowth with methotrexate treatment, which was generally safe, although some results were inconclusive due to follow-up issues.

research The Role of Micronutrients in Alopecia Areata: A Review

63 citations , May 2017 in “American Journal of Clinical Dermatology”

This review found that patients with alopecia areata may have lower levels of vitamin D, zinc, and folate, but conflicting evidence precludes definitive clinical recommendations for micronutrient supplementation.

research Best Dilution of the Best Corticosteroid for Intralesional Injection in the Treatment of Localized Alopecia Areata in Adults

22 citations , May 2017 in “Journal of dermatological treatment”

This study found that BD 1/4 dilution was the most effective corticosteroid concentration for intralesional injection to treat localized alopecia areata in adults, with fewer adverse effects than TA.

research Comorbidities in Patients with Alopecia Areata

56 citations , March 2017 in “Journal of the American Academy of Dermatology”

Alopecia areata patients often have eczema, thyroid issues, vitamin-D deficiency, and anemia.

research Changes of Serum Trace Elements Level in Patients with Alopecia Areata: A Meta-Analysis

23 citations , February 2017 in “Journal of dermatology”

This meta-analysis suggests that patients with alopecia areata have lower serum levels of zinc and selenium compared to healthy controls, which may be important risk factors for the condition.

research Syphilitic Alopecia: Case Reports and Trichoscopic Findings

29 citations , January 2017 in “Skin appendage disorders”

This case study highlights the importance of considering syphilis in the differential diagnosis for hair loss, as patients with the infection may present with non-typical alopecia patterns.

research Familial Aggregation of Alopecia Areata

295 citations , May 2016 in “Journal of the American Academy of Dermatology”

This review examines the immunological aspects of alopecia areata, focusing on genetic, neuroimmunological, and immune privilege factors, but does not report new clinical findings.

research Alopecia Areata and Health-Related Quality of Life: A Systematic Review and Meta-Analysis

128 citations , February 2016 in “British Journal of Dermatology”

This study found that patients with alopecia areata experience significant impairments in health-related quality of life, notably affecting mental health, according to various quality of life assessment tools.

research Biomarkers of Alopecia Areata Disease Activity and Response to Corticosteroid Treatment

65 citations , December 2015 in “Experimental dermatology”

This study found that both Th1 and Th2 immune responses, along with IL-23 and IL-32 cytokine pathways, are active in alopecia areata lesions, and corticosteroid injections significantly altered these immune markers.

research Benefit of Different Concentrations of Intralesional Triamcinolone Acetonide in Alopecia Areata: An Intrasubject Pilot Study

50 citations , July 2015 in “Journal of the American Academy of Dermatology”

This study found that 2.5 mg/mL triamcinolone acetonide injections were as effective as higher doses for treating limited, patchy alopecia areata, while minimizing side effects like skin atrophy.

research Epidemiology and Burden of Alopecia Areata: A Systematic Review

144 citations , July 2015 in “Clinical, Cosmetic and Investigational Dermatology”

This review reports that alopecia areata affects about 2% of people globally and is linked with psychiatric and medical comorbidities, highlighting its significant disease burden.

research Methotrexate in Severe Childhood Alopecia Areata: Long-Term Follow-Up

25 citations , June 2015 in “Acta dermato-venereologica”

Methotrexate can help some kids with severe hair loss regrow hair.

research The Genetics Of Alopecia Areata: New Approaches, New Findings, New Treatments

62 citations , January 2015 in “Journal of Dermatological Science”

This review summarizes the current genetic research on alopecia areata, including potential new therapeutic strategies, but reports no new clinical findings.

research Alopecia Areata as a Paraneoplastic Syndrome of Hodgkin’s Lymphoma: A Case Report

10 citations , April 2014 in “Molecular and Clinical Oncology”

This case report describes a 46-year-old male whose alopecia areata preceded and resolved with treatment for stage IVB classical Hodgkin's lymphoma, highlighting AA as a potential indicator of underlying malignancy, although such cases are rare and not well-characterized.

research Minoxidil Induced Hypertrichosis in a 2-Year-Old Child

17 citations , October 2013 in “F1000Research”

This case report details a 2-year-old boy who developed generalized hypertrichosis after using 5% minoxidil foam for alopecia areata, highlighting the importance of caution and proper administration instructions for young children.

research The Effect of Oral Cyclosporine in the Treatment of Severe Alopecia Areata

33 citations , October 2013 in “Cutaneous and ocular toxicology”

This article discusses the autoimmune pathogenesis of alopecia areata and reviews the use of immunosuppressive therapies in its treatment, but it does not provide new clinical results.

research The Basic Science of Hair Biology

29 citations , September 2012 in “Dermatologic Clinics”

This article reviews the causal mechanisms of hair follicle disorders, focusing on inflammation, genetics, environment, and hormones, but it reports no new clinical results.

research Alopecia Areata: An Autoimmune Disease Causing Hair Loss

421 citations , April 2012 in “The New England Journal of Medicine”

Alopecia Areata is an autoimmune condition causing hair loss with no cure and treatments that often don't work well.

research Investigation of the Male Pattern Baldness Major Genetic Susceptibility Loci AR/EDA2R and 20p11 in Female Pattern Hair Loss

38 citations , February 2012 in “British Journal of Dermatology”

This study suggests that the AR/EDA2R locus may contribute to early-onset female pattern hair loss, but no association was found with the 20p11 locus.

research Clinical Characteristics and Prognostic Factors in Early-Onset Alopecia Totalis and Alopecia Universalis

38 citations , January 2012 in “Journal of Korean Medical Science”

This study found that early-onset patients with alopecia universalis or a family history of alopecia areata showed worse prognosis compared to those with late-onset.

research Alopecia Areata: A New Treatment Plan

67 citations , July 2011 in “Clinical, cosmetic and investigational dermatology”

This review discusses various therapeutic agents for alopecia areata, categorized by efficacy and safety, and highlights the lack of curative treatments and long-term outcome studies.

research Quality of Life in Alopecia Areata: A Study of 60 Cases

44 citations , August 2010 in “Journal of Investigative Dermatology”

Alopecia areata seriously lowers quality of life, especially affecting self-image, mental health, and social life.

research Alopecia Areata Update

244 citations , January 2010 in “Journal of the American Academy of Dermatology”

This review discusses treatment options for alopecia areata and suggests tailored treatment plans, noting the challenges posed by spontaneous remission and limited high-quality clinical trials.

research Alopecia Areata Update

391 citations , January 2010 in “Journal of The American Academy of Dermatology”

This article reviews the clinical presentation and histopathologic features of alopecia areata and proposes a hypothesis for its development, but it reports no new clinical results.

research Alopecia Areata Incognita: A Hypothesis

60 citations , October 2009 in “Dermatology”

This article proposes a hypothesis for alopecia areata hair loss patterns and provides epidemiological evidence supporting distinct hair loss characteristics between general cases and those with androgenetic alopecia; it presents no new clinical results.

research Comma Hairs: A Dermatoscopic Marker for Tinea Capitis

143 citations , October 2008 in “Journal of The American Academy of Dermatology”

This study found that comma hairs are a distinctive feature of tinea capitis caused by Microsporum canis, distinguishing it from alopecia areata, which is characterized by exclamation mark hairs.

research Significance of Dermoscopy in Acute Diffuse and Total Alopecia of the Female Scalp: Review of Twenty Cases

42 citations , January 2008 in “Dermatology”

This study reports that dermoscopy is a useful diagnostic tool for distinguishing acute diffuse and total alopecia of the female scalp from female pattern hair loss by identifying specific hair features.