Alopecia areata: An appraisal of new treatment approaches and overview of current therapies

J Am Acad Dermatol. 2018 Jan;78(1):15-24. doi: 10.1016/j.jaad.2017.04.1142.


Many therapies are available for the treatment of alopecia areata, including topical, systemic, and injectable modalities. However, these treatment methods produce variable clinical outcomes and there are no currently available treatments that induce and sustain remission. When making management decisions, clinicians must first stratify patients into pediatric versus adult populations. Disease severity should then be determined (limited vs extensive) before deciding the final course of therapy. The second article in this continuing medical education series describes the evidence supporting new treatment methods, among them Janus kinase inhibitors. We evaluate the evidence concerning the efficacy, side effects, and durability of these medications. An overview of conventional therapy is also provided with new insights gleaned from recent studies. Finally, future promising therapeutic options that have not yet been fully evaluated will also be presented.

Keywords: JAK inhibitors; alopecia areata; alopecia totalis; alopecia universalis; corticosteroids; minoxidil; topical immunotherapy.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Administration, Topical
  • Adrenal Cortex Hormones / administration & dosage*
  • Alopecia Areata / immunology
  • Alopecia Areata / therapy*
  • Dermatologic Agents / therapeutic use
  • Education, Medical, Continuing
  • Female
  • Humans
  • Immunotherapy / methods
  • Injections, Intralesional
  • Male
  • Methotrexate / administration & dosage*
  • Minoxidil / therapeutic use*
  • Quality of Life*
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome


  • Adrenal Cortex Hormones
  • Dermatologic Agents
  • Minoxidil
  • Methotrexate