Treatment of alopecia areata with JAK inhibitors: a review of the literature.

Abstract

Alopecia areata (AA) is chronic autoimmune non-scarring hair loss, which can progress to alopecia totalis or universalis. Conventional treatments, such as corticosteroids and immunotherapies, often offer limited temporary benefits in moderate to severe cases. Recent advances have identified Janus kinase (JAK) inhibitors as a promising therapeutic option, targeting cytokine pathways involved in AA pathogenesis. This review explores the current evidence surrounding JAK inhibitors in the management of AA. Clinical trials and case series have demonstrated notable efficacy in promoting hair regrowth, even in extensive disease. Baricitinib and deuruxolitinib have shown particularly strong results, with significant scalp hair regrowth and acceptable safety profiles. Common adverse effects include acne, elevated lipid levels, and mild laboratory abnormalities, although long-term data remain limited. This review summarizes the mechanisms, efficacy outcomes, and safety data of various JAK inhibitors used in AA and highlights the need for further research to establish optimal dosing, treatment duration, and long-term safety.