S3 Guideline Diagnosis And Treatment Of Alopecia Areata – Part 2: Therapy, Psychosocial And Cosmetic Support

    August 2026 in “ JDDG Journal der Deutschen Dermatologischen Gesellschaft ”
    Ulrike Blume‐Peytavi, Andria Constantinou, Tsenka Tomova‐Simitchieva, Adrian Tanew, Michael Sticherling, Hermann Girschick, Annika Vogt, Uwe Schwichtenberg, Uwe Gieler, André Märtens, Kerstin Zienert, Claudia Stenders, Ricardo Niklas Werner, Doris Wilborn
    TLDR Topical corticosteroids are highly recommended for Alopecia areata, with systemic corticosteroids and Janus kinase inhibitors recommended for adults, and hair replacement options should be discussed with all patients.
    This document is the second part of the S3 guideline on the diagnosis and treatment of Alopecia areata (AA), focusing on therapy, quality of life, and support options. It highlights that topical corticosteroids are the only highly recommended topical treatment for AA, while other topical treatments have a low recommendation grade, varying by age group. For systemic therapy, only systemic corticosteroids and Janus kinase inhibitors are highly recommended, but only for adults. For children and adolescents with severe AA, corticosteroids, methotrexate, or Janus kinase inhibitors (if approved for their age group) can be offered, while other systemic treatments should not be. The guideline also advises that all AA patients, regardless of age, should be informed about hair replacement and cosmetic options.
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