Comparative analysis of therapeutic outcomes in pediatric versus adult ophiasis-pattern alopecia areata: A review of treatment modalities and disease course

January 2026 in “ Saudi Journal of Internal Medicine ”

Ahmed Mohammed Baabdullah

ophiasis-pattern alopecia areata corticosteroids Janus kinase inhibitors alopecia areata JAK inhibitors

TLDR More research is needed to confirm the best treatments for ophiasis-pattern alopecia areata in different age groups.

This review examines the treatment of ophiasis-pattern alopecia areata (OP) in both pediatric and adult populations, highlighting the effectiveness of corticosteroids and Janus kinase inhibitors. Despite these findings, the review emphasizes the need for more age-specific research to confirm the efficacy, durability, and safety of these treatments, as current evidence is limited.

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research Global Burden of Alopecia Areata and Associated Diseases: A Trend Analysis From 1990 to 2021

February 2025 in “PubMed”

Alopecia areata cases have increased globally, affecting mostly women aged 30-34, with links to other health issues.

research Innovative Strategies for the Discovery of New Drugs Against Alopecia Areata: Taking Aim at the Immune System

12 citations , October 2024 in “Expert Opinion on Drug Discovery”

New, effective treatments for alopecia areata require innovative approaches targeting the immune system.

research Dupilumab Induces Hair Regrowth in Pediatric Alopecia Areata: A Real-World, Single-Center Observational Study

20 citations , July 2024 in “Archives of Dermatological Research”

Dupilumab helps children with alopecia areata regrow hair safely.

research European Expert Consensus Statement on the Systemic Treatment of Alopecia Areata

4 citations , January 2024 in “JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology”

Baricitinib and ritlecitinib are recommended for severe alopecia areata, with other treatments available off-label.

research A Retrospective Review of Anthralin in Petrolatum in the Treatment of Alopecia Areata in the Pediatric Population

1 citations , August 2023 in “Journal of Cutaneous Medicine and Surgery”

Anthralin 0.2% is effective for hair regrowth in children with alopecia areata.

research Factors Predicting Response to Oral Methylprednisolone Tapering Treatment in Alopecia Areata: A Retrospective Study

1 citations , May 2023 in “Journal of the American Academy of Dermatology”

Younger patients and those with more hair loss are less likely to benefit from oral steroid treatment for hair loss, and low vitamin D may predict relapse.

research Efficacy and Safety of Ritlecitinib in Adults and Adolescents With Alopecia Areata: A Randomised, Double-Blind, Multicentre, Phase 2b–3 Trial

227 citations , April 2023 in “The Lancet”

Ritlecitinib effectively treats alopecia areata and is well-tolerated.

research Microneedling With Triamcinolone Acetonide Versus Intralesional Triamcinolone Acetonide in Treatment of Alopecia Areata

February 2023 in “Al-Azhar International Medical Journal /Al-Azhar International Medical Journal”

Microneedling with triamcinolone is a safe, effective, and less painful treatment for alopecia areata.

research New Treatment Strategies in Management of Alopecia Areata: A Review Article

January 2023 in “The Egyptian Journal of Hospital Medicine”

New treatments for sudden hair loss include oral medications and a special laser, both showing promise in hair regrowth.

research Clinical Response to Oral Tofacitinib in Pediatric Patients With Alopecia Areata

10 citations , August 2022 in “JAAD Case Reports”

Oral tofacitinib effectively regrows hair in children with alopecia areata without major side effects.

research The Psychological Consequences of Androgenetic Alopecia: A Systematic Review

1 citations , April 2022 in “Journal of Cosmetic Dermatology”

Androgenetic alopecia causes significant psychological distress, especially in women, and requires both medical and psychological support.

research Alopecia Areata and Dexamethasone Mini-Pulse Therapy: A Prospective Cohort Study on Real World Evidence and Factors Related to Successful Response

16 citations , March 2022 in “Journal of Clinical Medicine”

Dexamethasone mini-pulse therapy is effective for alopecia areata but less effective for those with early onset or hypothyroidism.

research Intralesional Vitamin D3 in Treatment of Alopecia Areata: A Randomized Controlled Clinical Trial

7 citations , February 2022 in “Journal of Cosmetic Dermatology”

Injecting vitamin D3 into the skin is an effective treatment for patchy hair loss.

research Trichotillomania: What Do We Know So Far?

8 citations , September 2021 in “Skin appendage disorders”

Trichotillomania treatment is most successful with a mix of behavioral therapy, medication, and social support.

research Sublingual Tofacitinib for Alopecia Areata: A Roll-Over Pilot Clinical Trial and Analysis of Pharmacokinetics

9 citations , May 2021 in “International Journal of Dermatology”

The trial showed that a new under-the-tongue treatment for severe hair loss was somewhat effective in a small group of people.

research Topical Tofacitinib for the Treatment of Alopecia Areata Affecting Facial Hair

7 citations , April 2021 in “British Journal of Dermatology”

Topical tofacitinib may effectively and safely regrow facial hair in some people with alopecia areata.

research A Phase 2a Randomized, Placebo-Controlled Study to Evaluate the Efficacy and Safety of the Oral Janus Kinase Inhibitors Ritlecitinib and Brepocitinib in Alopecia Areata: 24-Week Results

138 citations , March 2021 in “Journal of the American Academy of Dermatology”

Ritlecitinib and brepocitinib effectively regrow hair in alopecia areata patients.

research A Randomized Comparative Study of the Efficacy of Topical Latanoprost Versus Topical Betamethasone Dipropionate Lotion in the Treatment of Localized Alopecia Areata

2 citations , January 2021 in “Indian Journal of Dermatology, Venereology and Leprology”

Betamethasone is more effective for hair regrowth than latanoprost but has more side effects.

research Candida Antigen Immunotherapy Versus Steroid in the Treatment of Alopecia Areata

1 citations , January 2021 in “Dermatologic Therapy”

Candida antigen is an effective and promising treatment for alopecia areata.

research Alopecia Areata: A Review on Diagnosis, Immunological Etiopathogenesis, and Treatment Options

56 citations , January 2021 in “Clinical and Experimental Medicine”

The document concludes that while there are various treatments for Alopecia Areata, there is no cure, and individualized treatment plans are essential due to varying effectiveness.

research A Retrospective Comparative Study of Two Concentrations of Intralesional Triamcinolone Acetonide in the Treatment of Patchy Alopecia Areata on the Scalp

6 citations , November 2020 in “Clinical Cosmetic and Investigational Dermatology”

Both concentrations of triamcinolone acetonide are effective for hair regrowth in patchy alopecia areata, but 5 mg/mL is recommended to reduce side effects.

research Low-Dose IL-2 for Treating Moderate to Severe Alopecia Areata: A 52-Week Multicenter Prospective Placebo-Controlled Study Assessing Its Impact on T Regulatory Cell and NK Cell Populations

22 citations , September 2020 in “The journal of investigative dermatology/Journal of investigative dermatology”

The study's results on the effectiveness of low-dose IL-2 for alopecia areata and its impact on immune cells were not provided.

research Hair Follicle Immune Privilege and Its Collapse in Alopecia Areata

134 citations , July 2020 in “Experimental dermatology”

Hair follicles are normally protected from the immune system, but when this protection fails, it can cause hair loss in alopecia areata.

research Efficacy of Intradermal Minoxidil 5% Injections for Treatment of Patchy Non-Severe Alopecia Areata

4 citations , July 2020 in “Journal of Dermatological Treatment”

Minoxidil injections can speed up hair regrowth in non-severe patchy hair loss, but combining it with steroids doesn't improve results.

research Comparative Study Between Fractional Carbon Dioxide Laser vs Intralesional Steroid Injection in Treatment of Alopecia Areata

18 citations , June 2020 in “Dermatologic Therapy”

FCO2 laser is a better treatment for alopecia areata than intralesional steroids.

Efficacy of Postbiotics in a PRP-Like Cosmetic Product for the Treatment of Alopecia Areata: A Randomized Double-Blinded Parallel-Group Study

research Efficacy of Postbiotics in a PRP-Like Cosmetic Product for the Treatment of Alopecia Areata: A Randomized Double-Blinded Parallel-Group Study

17 citations , April 2020 in “Dermatology and Therapy”

The PRP-like cosmetic product with postbiotics effectively treats hair loss in Alopecia areata.

Combination of Photodynamic Therapy with 5-Aminolaevulinic Acid and Microneedling in the Treatment of Alopecia Areata Resistant to Conventional Therapies: Our Experience with 41 Patients

research Combination of Photodynamic Therapy with 5-Aminolaevulinic Acid and Microneedling in the Treatment of Alopecia Areata Resistant to Conventional Therapies: Our Experience with 41 Patients

14 citations , August 2019 in “Clinical and Experimental Dermatology”

Combining light therapy, acid, and microneedling improves hair regrowth in stubborn hair loss cases.

research Weekly Azathioprine Pulse Versus Betamethasone Oral Mini-Pulse in the Treatment of Moderate-to-Severe Alopecia Areata

10 citations , July 2019 in “Indian Journal of Dermatology”

Weekly azathioprine pulse is a better alternative to corticosteroids for treating alopecia areata due to fewer side effects.

research Topical Calcipotriol vs Narrowband Ultraviolet B in Treatment of Alopecia Areata: A Randomized-Controlled Trial

9 citations , June 2019 in “Archives of Dermatological Research”

Both topical calcipotriol and narrowband UVB improved alopecia, but combining them didn't enhance the effect on hair loss severity, despite higher vitamin D3 levels.

research Cyclosporine for Moderate-to-Severe Alopecia Areata: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial of Efficacy and Safety

44 citations , April 2019 in “Journal of the American Academy of Dermatology”

Cyclosporine showed some improvement in alopecia areata but results were not statistically significant.

research Janus Kinase Inhibitors for the Treatment of Severe Alopecia Areata: An Open-Label Comparative Study

66 citations , December 2018 in “Dermatology”

Both ruxolitinib and tofacitinib are effective and safe for treating severe alopecia areata, but relapses are common.

research Randomized Controlled Trial on a PRP-Like Cosmetic with Biomimetic Peptides for the Treatment of Alopecia Areata

8 citations , December 2018 in “Journal of Dermatological Treatment”

The PRP-like cosmetic with biomimetic peptides is potentially effective and safe for treating alopecia areata.

A Randomized Placebo-Controlled Single-Center Pilot Study of the Safety and Efficacy of Apremilast in Subjects with Moderate-to-Severe Alopecia Areata

research A Randomized Placebo-Controlled Single-Center Pilot Study of the Safety and Efficacy of Apremilast in Subjects with Moderate-to-Severe Alopecia Areata

42 citations , November 2018 in “Archives of dermatological research”

Apremilast was not effective in treating moderate-to-severe alopecia areata.

HRQoL in Hair Loss-Affected Patients with Alopecia Areata, Androgenetic Alopecia, and Telogen Effluvium: The Role of Personality Traits and Psychosocial Anxiety

research HRQoL in Hair Loss-Affected Patients with Alopecia Areata, Androgenetic Alopecia, and Telogen Effluvium: The Role of Personality Traits and Psychosocial Anxiety

29 citations , November 2018 in “Journal of The European Academy of Dermatology and Venereology”

Personality traits and anxiety affect hair loss patients' quality of life.

research Treatment of Alopecia Universalis with Topical Janus Kinase Inhibitors – A Double Blind, Placebo, and Active Controlled Pilot Study

49 citations , August 2018 in “International Journal of Dermatology”

Topical JAK inhibitors may help treat alopecia universalis by promoting hair regrowth.

research Topical 2% Tofacitinib for Children with Alopecia Areata, Alopecia Totalis, and Alopecia Universalis

49 citations , May 2018 in “Journal of the American Academy of Dermatology”

Applying 2% tofacitinib cream helped some children with severe hair loss grow back hair.

research Study of the Efficacy of Carboxytherapy in Alopecia

16 citations , February 2018 in “Journal of Cosmetic Dermatology”

Carboxytherapy may help increase hair growth in alopecia patients but requires ongoing treatment.

Nail Involvement in Alopecia Areata: A Questionnaire-Based Survey on Clinical Signs, Impact on Quality of Life, and Review of the Literature

research Nail Involvement in Alopecia Areata: A Questionnaire-Based Survey on Clinical Signs, Impact on Quality of Life, and Review of the Literature

19 citations , January 2018

Most people with alopecia areata have nail changes, which are common but don't greatly affect their quality of life.

Use of Adapalene in Alopecia Areata: Efficacy and Safety of Mometasone Furoate 0.1% Cream Versus Combination of Mometasone Furoate 0.1% Cream and Adapalene 0.1% Gel in Alopecia Areata

research Use of Adapalene in Alopecia Areata: Efficacy and Safety of Mometasone Furoate 0.1% Cream Versus Combination of Mometasone Furoate 0.1% Cream and Adapalene 0.1% Gel in Alopecia Areata

6 citations , November 2017 in “Dermatologic Therapy”

Combining mometasone furoate cream with adapalene gel is safer and more effective for hair regrowth in alopecia areata than using the cream alone.

research Topical Janus Kinase Inhibitors for the Treatment of Pediatric Alopecia Areata

83 citations , June 2017 in “Journal of the American Academy of Dermatology”

Topical JAK inhibitors may help children with alopecia areata regrow hair.

research Higher Concentrations of Dithranol Appear to Induce Hair Growth Even in Severe Alopecia Areata

12 citations , June 2017 in “Dermatologic therapy”

Higher concentrations of dithranol can help regrow hair in severe alopecia areata.

research High-Dose Pulsed Corticosteroid Therapy Combined with Methotrexate for Severe Alopecia Areata in Childhood

15 citations , May 2017 in “JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology”

High-dose corticosteroids and methotrexate had a modest effect on severe childhood alopecia, but side effects and relapse were concerns.

research Efficacy of Topical Latanoprost Versus Minoxidil and Betamethasone Valerate on the Treatment of Alopecia Areata

15 citations , May 2017 in “Journal of Dermatological Treatment”

Latanoprost works better for hair growth, and combining it with betamethasone valerate is most effective.

research Best Dilution of the Best Corticosteroid for Intralesional Injection in the Treatment of Localized Alopecia Areata in Adults

22 citations , May 2017 in “Journal of dermatological treatment”

BD 1/4 dilution is the best for treating localized alopecia areata in adults.

research Efficacy and Safety of Topical Calcipotriol in Management of Alopecia Areata: A Pilot Study

39 citations , January 2017 in “Dermatologic Therapy”

Topical calcipotriol may help treat alopecia areata, especially in those with low vitamin D.

research Bilateral Half-Head Comparison of 1% Anthralin Ointment in Children with Alopecia Areata

24 citations , January 2017 in “Pediatric dermatology”

1% anthralin ointment is effective and safe for treating severe alopecia areata in children.

research Stem Cell Therapy as a Novel Therapeutic Intervention for Resistant Cases of Alopecia Areata and Androgenetic Alopecia

39 citations , August 2016 in “Journal of Dermatological Treatment”

Stem cell therapy may help treat tough hair loss cases.

Possible Advantage of Imiquimod and Diphenylcyclopropenone Combined Treatment Versus Diphenylcyclopropenone Alone: An Observational Study of Nonresponder Patients With Alopecia Areata

research Possible Advantage of Imiquimod and Diphenylcyclopropenone Combined Treatment Versus Diphenylcyclopropenone Alone: An Observational Study of Nonresponder Patients With Alopecia Areata

9 citations , April 2016 in “Australasian journal of dermatology”

Combining imiquimod with diphenylcyclopropenone may improve treatment outcomes for alopecia areata patients who don't respond to diphenylcyclopropenone alone.

research Combined Oral Pulse and Topical Corticosteroid Therapy for Severe Alopecia Areata in Children: A Long-Term Follow-Up Study

28 citations , July 2015 in “Dermatologic therapy”

The combined therapy was effective and safe for children with severe alopecia areata.

research Bimatoprost Versus Mometasone Furoate in the Treatment of Scalp Alopecia Areata: A Pilot Study

36 citations , January 2015 in “Dermatology”

Bimatoprost was found to be safer and more effective than mometasone furoate for treating scalp hair loss.

research Vitamin D Deficiency in Alopecia Areata

105 citations , March 2014 in “British journal of dermatology/British journal of dermatology, Supplement”

Alopecia areata patients often have low vitamin D levels, suggesting they might benefit from vitamin D supplements.

research Clobetasol Propionate, 0.05%, vs Hydrocortisone, 1%, for Alopecia Areata in Children

49 citations , November 2013 in “JAMA dermatology”

Clobetasol propionate, 0.05%, is more effective and safe for treating childhood alopecia areata than hydrocortisone, 1%.

research Prognostic Factors That Affect the Response to Topical Treatment in Patchy Alopecia Areata

13 citations , November 2012 in “Journal of The European Academy of Dermatology and Venereology”

Certain factors like allergies, nail problems, and hair loss patterns can predict how well someone with patchy hair loss will respond to skin cream treatments.

research A Study to Evaluate the Efficacy of Various Topical Treatment Modalities for Alopecia Areata

20 citations , January 2012 in “International journal of trichology”

Steroids are the best treatment for Alopecia Areata with few side effects.

Randomized Comparison of Topical Betamethasone Valerate Foam, Intralesional Triamcinolone Acetonide, and Tacrolimus Ointment in Management of Localized Alopecia Areata

research Randomized Comparison of Topical Betamethasone Valerate Foam, Intralesional Triamcinolone Acetonide, and Tacrolimus Ointment in Management of Localized Alopecia Areata

48 citations , January 2011 in “International journal of trichology”

Intralesional triamcinolone acetonide is the most effective treatment for localized alopecia areata.

research Alopecia Areata Update

391 citations , January 2010 in “Journal of The American Academy of Dermatology”

Half of people with Alopecia Areata may see hair regrowth within a year without treatment, but recovery is unpredictable.

research Efficacy And Safety Of A New Clobetasol Propionate 0.05% Foam In Alopecia Areata: A Randomized, Double-Blind Placebo-Controlled Trial

114 citations , October 2006 in “Journal of the European Academy of Dermatology and Venereology”

The new clobetasol propionate foam is effective and safe for treating alopecia areata.