Case Report: Repigmentation and Complete Hair Regrowth in an 11-Year-Old Preadolescent with Alopecia Totalis Treated with a JAK Inhibitor

An 11-year-old girl with alopecia totalis experienced complete hair regrowth and repigmentation from white to black hair after treatment with JAK inhibitors. Initially treated with baricitinib for seven months, she achieved 65% hair regrowth with predominantly white and gray hair. Upon switching to ritlecitinib 50 mg/day, black hair began to emerge at six weeks, and complete regrowth and repigmentation were observed at six months. After 12 months of ritlecitinib therapy, the patient maintained a stable response with no significant adverse effects, and her Family Dermatology Life Quality Index improved from 18 to 4. This case indicates that prolonged JAK inhibition may promote both hair regrowth and pigment restoration in severe pediatric alopecia areata.