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Alopecia Areata: Prevention and Management
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Alopecia Areata: Prevention and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: closed (30 April 2025) | Viewed by 7086

Special Issue Editor

Dr. Anna Waśkiel-Burnat

E-Mail Website
Guest Editor
Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warsaw, Poland
Interests: hair disorders; hair loss; trichoscopy; scalp diseases

Special Issue Information

Dear Colleagues,

Alopecia areata is an autoimmune form of hair loss that affects approximately 2% of the general population.

The role of the collapse of the hair follicle’s immune privilege in alopecia areata has been well described. However, the exact cause of the disease remains unknown. Genetic and environmental factors, such as psychological stress, infections, toxins, and even food, have been suggested to be associated with autoimmune dysregulation processes in patients with alopecia areata. Moreover, the role of microbiome in the pathogenesis of the disease has been recently discussed.

A better understanding of the immunologic inflammatory pathways of alopecia areata have shed new light on alopecia areata treatment. Novel insights in breakthrough therapeutics have changed the landscape of alopecia areata in the last decade.

The aim of this Special Issue is to present cutting-edge studies considering the prevention and treatment of alopecia areata.

Dr. Anna Waśkiel-Burnat
Guest Editor

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Keywords

  • alopecia areata
  • hair loss
  • JAK inhibitors
  • treatment
  • corticosteroids
  • cyclosporin
  • methotrexate
  • baricitinib
  • ritlecitinib

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Published Papers (2 papers)

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13 pages, 4815 KiB  
Systematic Review
Safety and Efficacy of Ritlecitinib for the Treatment of Patients with Alopecia Areata: A Systematic Review and Meta-Analysis of Controlled Trials
by Samah Omar Ali Alfahl and Abdullateef Alzolibani
J. Clin. Med. 2025, 14(6), 1817; https://doi.org/10.3390/jcm14061817 - 8 Mar 2025
Viewed by 1472
Abstract
Background: Alopecia areata (AA) typically presents as round patches of hair loss (e.g., scalp, eyebrow/eyelash, and body), has an unpredictable disease course, and may relapse and remit. AA is a condition with a lifetime risk of approximately 2% in the global population [...] Read more.
Background: Alopecia areata (AA) typically presents as round patches of hair loss (e.g., scalp, eyebrow/eyelash, and body), has an unpredictable disease course, and may relapse and remit. AA is a condition with a lifetime risk of approximately 2% in the global population with an annual incidence rate ranging from 2.53 to 26 per 100,000. This comprehensive systematic review and meta-analysis was performed to determine the safety and efficacy of Ritlecitinib in patients with AA. Methods: A systematic search was conducted in PubMed and Cochrane CENTRAL Library for randomized controlled trials (RCTs). We used mean difference with 95% confidence intervals to assess the effectiveness and odds ratio to assess the safety profile. A total of 65 publications were identified through a database search. Following two stages of screening, we included 13 publications. All the studies were parallel and double-blind RCTs and published between 2020 and 2022. Results: Our analysis revealed a significant reduction in SALT score at week 12 and week 24 of (−17.43 [−24.67 to −10.20]; p < 0.0001) and (−20.95 [−29.01 to −12.89]; p < 0.0001), respectively, in patients treated with Ritlecitinib compared to placebo. Furthermore, a significant improvement in PGIC score at week 24 was observed. Additionally, Ritlecitinib revealed a slightly higher reduction in AASIS score compared to placebo; however, this difference was statistically non-significant. Notably, the Ritlecitinib group experienced a higher frequency of headaches, acne and nasopharyngitis compared to placebo, while the placebo group reported a greater occurrence of serious adverse events compared to the Ritlecitinib group. This higher rate of serious events in the placebo arm could be explained by the placebo effect, although these differences were statistically non-significant. Conclusions: These findings suggest that Ritlecitinib holds promise as an effective treatment for AA with an acceptable safety profile, warranting further investigation in larger cohorts and long-term studies. Full article
(This article belongs to the Special Issue Alopecia Areata: Prevention and Management)
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11 pages, 2022 KiB  
Systematic Review
The Role of Minoxidil in Treatment of Alopecia Areata: A Systematic Review and Meta-Analysis
by Michał Majewski, Karolina Gardaś, Anna Waśkiel-Burnat, Michał Ordak and Lidia Rudnicka
J. Clin. Med. 2024, 13(24), 7712; https://doi.org/10.3390/jcm13247712 - 17 Dec 2024
Cited by 1 | Viewed by 5232
Abstract
Background/Objectives: Minoxidil, in addition to its vasodilatory effect, has also immunomodulatory properties that may be partially responsible for its efficacy in alopecia areata. The aim of the study was to evaluate the efficacy of monotherapy with topical or oral minoxidil in alopecia [...] Read more.
Background/Objectives: Minoxidil, in addition to its vasodilatory effect, has also immunomodulatory properties that may be partially responsible for its efficacy in alopecia areata. The aim of the study was to evaluate the efficacy of monotherapy with topical or oral minoxidil in alopecia areata. Methods: A systematic review and meta-analysis of the efficacy of monotherapy with minoxidil in alopecia areata was conducted following the PRISMA guidelines. Efficacy of minoxidil in alopecia areata was evaluated separately for three groups of the patients: (1) treated with 5% topical minoxidil, (2) less than 5% topical minoxidil, and (3) oral minoxidil. Therapeutic response was defined as any regrowth of terminal hair. Results: Of 244 articles, 13 were considered eligible for the further analysis. The study included 372 patients with alopecia areata (338 using topical minoxidil and 34 taking oral minoxidil). The mean time of treatment ranged from 2 to 60 weeks (mean: 27 weeks). The response rate for 5% topical was 82% (95% CI 0.7–0.93) and 58% (95% Cl 0.5–0.67) for the less than 5% topical minoxidil group. For the group of patients treated orally, the response rate was 82%. Conclusions: Minoxidil, both topical and oral, may be beneficial in monotherapy in patients with alopecia areata. 5% topical minoxidil is characterized by significantly higher efficacy compared to minoxidil at a lower concentration. There are no sufficient data to recommend minoxidil as a first-line therapeutic option for alopecia areata. Full article
(This article belongs to the Special Issue Alopecia Areata: Prevention and Management)
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