Defining Alopecia Areata Severity and Navigating Treatment Options

An expert discusses how treatment for alopecia areata begins with topical/intralesional therapies for limited disease and progresses to systemic options for extensive involvement or treatment resistance. Treatment decisions are guided by disease severity, patient age, comorbidities, and treatment goals. FDA-approved systemic agents include ritlecitinib (JAK3/TEC inhibitor) and baricitinib (JAK1/2 inhibitor), which block inflammatory pathways to promote hair regrowth with favorable efficacy, though they require monitoring for potential adverse effects.