Treatment of Pediatric Alopecia Areata: A Systematic Review

The systematic review on pediatric alopecia areata (AA) treatments highlights that high-potency topical corticosteroids are the preferred first-line treatment due to their high level of evidence, though they can cause side effects like skin atrophy. Intralesional corticosteroids are effective but less common due to pain, and systemic corticosteroids, while showing a 45% complete response rate in 272 patients, have significant side effects. Other treatments like methotrexate, minoxidil, and Janus kinase inhibitors show varying degrees of promise but require more pediatric-specific trials to confirm their safety and efficacy. The review emphasizes the need for more rigorous, large-scale clinical trials to establish standardized treatment protocols and better guide the management of pediatric AA, considering its significant psychosocial impact.