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A consensus-based treatment algorithm for alopecia areata in adolescents and adults: integrating severity, quality of
Charles W Lynde1, Lyn Guenther2, Anneke Andriessen3
1Lynde Institute for Dermatology and Lynderm Research Inc., Markham, ON, Canada.
Introduction:
Alopecia areata (AA) is an autoimmune, inflammatory condition characterized by non-scarring hair loss on the scalp, face, or body. It can significantly affect a person's quality of life (QoL) and mental health.
Methods:
Using a modified Delphi method, a panel of expert dermatologists developed a practical treatment algorithm to help clinicians deliver personalized, safe care to diverse patients with AA.
Results:
The approach to the algorithm introduces a broader definition of disease severity, incorporating not only Severity of Alopecia Tool (SALT) scores but also quality-of-life impact and the rate of disease progression.
Discussion:
Recent therapeutic advances have expanded access to effective, safe treatments for a broader population of AA patients. Ritlecitinib, a Janus kinase 3/TEC inhibitor, is currently the only oral Janus kinase inhibitor approved for adolescents and adults aged 12 years and older, whereas baricitinib, a Janus kinase1/2 inhibitor, is approved for adults aged 18 years and older. However, questions on the long-term safety of these therapies, access, and personalization still need to be addressed.
Conclusion:
Future efforts should validate and refine the algorithm across real-world cohorts and ensure equitable access to personalized treatment for patients with AA.
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