Opinion|Videos|March 4, 2025

Defining Alopecia Areata Severity and Navigating Treatment Options

An expert discusses how treatment for alopecia areata begins with topical/intralesional therapies for limited disease and progresses to systemic options for extensive involvement or treatment resistance. Treatment decisions are guided by disease severity, patient age, comorbidities, and treatment goals. FDA-approved systemic agents include ritlecitinib (JAK3/TEC inhibitor) and baricitinib (JAK1/2 inhibitor), which block inflammatory pathways to promote hair regrowth with favorable efficacy, though they require monitoring for potential adverse effects.

Video content above is prompted by the following:

  • Describe your approach to initiating treatment in patients with alopecia areata. At what point do you consider systemic treatment for your patients?
  • What factors guide your treatment decisions (severity, patient characteristics, patient expectations, etc)?
  • Briefly discuss the systemic agents that are currently FDA approved for alopecia areata, including their mechanism of action as well as efficacy and safety data.
    • Ritlecitinib (JAK3/TEC inhibitor)
    • Baricitinib (JAK 1/2 inhibitor)

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