Alopecia Areata Treatment: Past, Present, and Future

Background

Alopecia Areata (AA) is an autoimmune disorder resulting in non-scarring hair loss on the scalp, face, and body. AA research has experienced significant advancements within the last century with the discoveries of the autoimmune nature of the disorder and the role of genetic and psychosocial factors. This review provides a comprehensive dive into the history and evolution of AA management with a focus on the recently FDA-approved JAK inhibitors baricitinib, ritlecitinib, and deuruxolitinib, and sheds light on emerging therapies.

Methods

A search was conducted on PubMed to investigate literature on the history of AA treatment, current AA treatment with a focus on therapy with JAK inhibitors, and the future directions of AA treatment.

Results

Caustic topical agents were used as the main AA therapy until recent decades. The last century saw significant advancements in understanding the etiology of AA as autoimmune, genetic, and psychosocial, influencing the directions of treatment research. In recent years, JAK inhibitors were found to be an effective, systemic AA treatment. Non-systemic AA therapies such as corticosteroid injections, topical minoxidil, contact immunotherapy, and red-laser light therapy remain effective treatments. JAK inhibitors continue to be the focus of AA treatment research, although other targets and new treatment modalities are being studied.

Conclusion

The treatment of AA has undergone significant advances within recent years, especially with the application of JAK inhibitors as systemic therapy. Future research should investigate the therapeutic potential of stem cell therapy, gene therapy, and energy-assisted drug delivery (LEADD) for AA.