Alopecia areata. Diagnostic and therapeutic recommendations of the Polish Society of Dermatology. Part 2: Treatment

Abstract

The treatment goal in alopecia areata is induction of hair regrowth and halting the progression of the disease. Treatment decisions depend on the severity of the alopecia areata as assessed by the Severity of Alopecia Tool (SALT) or the Alopecia Areata Scale (AAS). In mild alopecia areata, very ultra-high potency topical glucocorticoids and intralesional triamcinolone acetonide are the mainstay of treatment. In moderate to severe alopecia areata, systemic treatment is usually required. Currently, the only drug dedicated for alopecia areata, approved in Europe and the United States is baricitinib. Ritlecitinib, a JAK3/TEC inhibitor is expected to be the second approved drug for this indication in the up-coming future. Other systemic medications used in alopecia areata also include glucocorticoids, cyclosporine, and methotrexate. Contact immunotherapy may be considered. In alopecia areata, long-maintenance treatment is of substantial significance.