Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Pediatric Drugs
Published in: Pediatric Drugs 3/2024

11-03-2024 | Minoxidil | Review Article

Treatment Options for Alopecia Areata in Children and Adolescents

Authors: Linnea L. Westerkam, Diana B. McShane, Elizabeth L. Nieman, Dean S. Morrell

Published in: Pediatric Drugs | Issue 3/2024

Login to get access

Abstract

Alopecia areata (AA) lifetime incidence is around 2%, with many patients first experiencing symptoms during childhood. However, ritlecitinib is the only FDA-approved treatment for pediatric patients 12 years and older. This review outlines reported topical, injectable, and oral treatment options for pediatric patients with AA. Clinical studies were obtained via a PubMed search using the following search terms: alopecia areata, areata, universalis, or totalis and medication, therapy, treatment, drug, or management. Only studies with pediatric patients were included in this review. Commonly used therapies, including corticosteroids, methotrexate, and minoxidil, newer promising medications, such as Janus kinase inhibitors, and less frequently used topical and systemic treatments are included. A summary of the drug development pipeline and ongoing interventional clinical trials with pediatric patients is provided. Treatments demonstrate variable efficacy, and many patients require combination therapy for maximal response. More robust clinical data is needed for many of the medications reviewed in order to provide better care for these patients.
Appendix
Available only for authorised users
Literature
1.
2.
3.
4.
5.
6.
7.
8.
Olsen EA, Hordinsky MK, Price VH, Roberts JL, Shapiro J, Canfield D, Duvic M, King LE Jr, McMichael AJ, Randall VA, Turner ML, Sperling L, Whiting DA, Norris D; National Alopecia Areata Foundation. Alopecia areata investigational assessment guidelines—Part II. National Alopecia Areata Foundation. J Am Acad Dermatol. 2004;51(3):440–7. https://​doi.​org/​10.​1016/​j.​jaad.​2003.​09.​032.
9.
Olsen EA, Hordinsky MK, Price VH, Roberts JL, Shapiro J, Canfield D, Duvic M, King LE Jr, McMichael AJ, Randall VA, Turner ML, Sperling L, Whiting DA, Norris D. Severity of Alopecia Tool (SALT) scoring tool.
10.
11.
12.
13.
14.
Lenane P, Macarthur C, Parkin PC, et al. Clobetasol propionate, 0.05%, vs hydrocortisone, 1%, for alopecia areata in children: a randomized clinical trial. JAMA Dermatol. 2014;150(1):47–50.PubMedCrossRef
15.
Montes LF. Topical halcinonide in alopecia areata and in alopecia totalis. J Cutan Pathol. 1977;4(2):47–50.PubMedCrossRef
16.
Meah N, Wall D, York K, Bhoyrul B, Bokhari L, Sigall DA, Bergfeld WF, Betz RC, Blume-Peytavi U, Callender V, Chitreddy V, Combalia A, Cotsarelis G, Craiglow B, Donovan J, Eisman S, Farrant P, Green J, Grimalt R, Harries M, Hordinsky M, Irvine AD, Itami S, Jolliffe V, King B, Lee WS, McMichael A, Messenger A, Mirmirani P, Olsen E, Orlow SJ, Piraccini BM, Rakowska A, Reygagne P, Roberts JL, Rudnicka L, Shapiro J, Sharma P, Tosti A, Vogt A, Wade M, Yip L, Zlotogorski A, Sinclair R. The Alopecia Areata Consensus of Experts (ACE) study: Results of an international expert opinion on treatments for alopecia areata. J Am Acad Dermatol. 2020;83(1):123–30. https://​doi.​org/​10.​1016/​j.​jaad.​2020.​03.​004. (Epub 2020 Mar 9).CrossRefPubMed
17.
Chang KH, Rojhirunsakool S, Goldberg LJ. Treatment of severe alopecia areata with intralesional steroid injections. J Drugs Dermatol. 2009;8(10):909–12.PubMed
18.
Abell E, Munro DD. Intralesional treatment of alopecia areata with triamcinolone acetonide by jet injector. Br J Dermatol. 1973;88(1):55–9.PubMedCrossRef
19.
20.
Abdallah MAE, Shareef R, Soltan MY. Efficacy of intradermal minoxidil 5% injections for treatment of patchy non-severe alopecia areata. J Dermatol Treat. 2022;33(2):1126–9.CrossRef
21.
Fenton DA, Wilkinson JD. Topical minoxidil in the treatment of alopecia areata. Br Med J (Clin Res Ed). 1983;287(6398):1015–7.PubMedCrossRef
22.
Price VH. Double-blind, placebo-controlled evaluation of topical minoxidil in extensive alopecia areata. J Am Acad Dermatol. 1987;16(3 Pt 2):730–6.PubMedCrossRef
23.
Georgala S, Befon A, Maniatopoulou E, Georgala C. Topical use of minoxidil in children and systemic side effects. Dermatology. 2007;214(1):101–2.PubMedCrossRef
24.
25.
Weiss VC, West DP, Mueller CE. Topical minoxidil in alopecia areata. J Am Acad Dermatol. 1981;5(2):224–6.PubMedCrossRef
26.
27.
Craiglow BG, Tavares D, King BA. Topical ruxolitinib for the treatment of alopecia universalis. JAMA Dermatol. 2016;152(4):490–1.PubMedCrossRef
28.
Bayart CB, DeNiro KL, Brichta L, Craiglow BG, Sidbury R. Topical Janus kinase inhibitors for the treatment of pediatric alopecia areata. J Am Acad Dermatol. 2017;77(1):167–70.PubMedCrossRef
29.
Putterman E, Castelo-Soccio L. Topical 2% tofacitinib for children with alopecia areata, alopecia totalis, and alopecia universalis. J Am Acad Dermatol. 2018;78(6):1207-1209.e1.PubMedCrossRef
30.
Khan FA, Hussain M, Khan BM, et al. Comparative study between intralesional injection of platelet rich plasma and intra lesional triamcinolone for the treatment of alopecia areata. J Ayub Med Coll Abbottabad. 2022;34(4):762–5.PubMedCrossRef
31.
32.
33.
Sarifakioglu E, Degim IT, Gorpelioglu C. Determination of the sildenafil effect on alopecia areata in childhood: An open-pilot comparison study. J Dermatol Treat. 2006;17(4):235–7.CrossRef
34.
Borchert M, Bruce S, Wirta D, et al. An evaluation of the safety and efficacy of bimatoprost for eyelash growth in pediatric subjects. Clin Ophthalmol. 2016;10:419–29 (Published 2016 Mar 10).PubMedPubMedCentral
35.
Zaheri S, Hughes B. Successful use of bimatoprost in the treatment of alopecia of the eyelashes. Clin Exp Dermatol. 2010;35(4):e161–2.PubMedCrossRef
36.
Li AW, Antaya RJ. Successful treatment of pediatric alopecia areata of the scalp using topical bimatoprost. Pediatr Dermatol. 2016;33(5):e282–3.PubMedCrossRef
37.
Mehta JS, Raman J, Gupta N, Thoung D. Cutaneous latanoprost in the treatment of alopecia areata. Eye (Lond). 2003;17(3):444–6.PubMedCrossRef
38.
Bhat S, Handa S, De D. A randomized comparative study of the efficacy of topical latanoprost versus topical betamethasone diproprionate lotion in the treatment of localized alopecia areata. Indian J Dermatol Venereol Leprol. 2021;87(1):42–8.PubMedCrossRef
39.
Coronel-Pérez IM, Rodríguez-Rey EM, Camacho-Martínez FM. Latanoprost in the treatment of eyelash alopecia in alopecia areata universalis. J Eur Acad Dermatol Venereol. 2010;24(4):481–5.PubMedCrossRef
40.
El-Ashmawy AA, El-Maadawy IH, El-Maghraby GM. Efficacy of topical latanoprost versus minoxidil and betamethasone valerate on the treatment of alopecia areata. J Dermatolog Treat. 2018;29(1):55–64.PubMedCrossRef
41.
Yadav S, Dogra S, Kaur I. An unusual anatomical colocalization of alopecia areata and vitiligo in a child, and improvement during treatment with topical prostaglandin E2. Clin Exp Dermatol. 2009;34(8):e1010–1.PubMedCrossRef
42.
Hill ND, Bunata K, Hebert AA. Treatment of alopecia areata with squaric acid dibutylester. Clin Dermatol. 2015;33(3):300–4.PubMedCrossRef
43.
Giannetti A, Orecchia G. Clinical experience on the treatment of alopecia areata with squaric acid dibutyl ester. Dermatologica. 1983;167(5):280–2.PubMedCrossRef
44.
Tosti A, Guidetti MS, Bardazzi F, Misciali C. Long-term results of topical immunotherapy in children with alopecia totalis or alopecia universalis. J Am Acad Dermatol. 1996;35(2 Pt 1):199–201.PubMedCrossRef
45.
Pardasani AG, Turner E, McMichael AJ. Squaric acid dibutylester: indications for use and efficacy in alopecia areata. Arch Dermatol. 2001;137(7):970–2.PubMed
46.
Salsberg JM, Donovan J. The safety and efficacy of diphencyprone for the treatment of alopecia areata in children. Arch Dermatol. 2012;148(9):1084–5.PubMedCrossRef
47.
Schuttelaar ML, Hamstra JJ, Plinck EP, et al. Alopecia areata in children: treatment with diphencyprone. Br J Dermatol. 1996;135(4):581–5.PubMedCrossRef
48.
Hull SM, Pepall L, Cunliffe WJ. Alopecia areata in children: response to treatment with diphencyprone. Br J Dermatol. 1991;125(2):164–8.PubMedCrossRef
49.
Orecchia G, Rabbiosi G. Treatment of alopecia areata with diphencyprone. Dermatologica. 1985;171(3):193–6.PubMedCrossRef
50.
Luk NM, Chiu LS, Lee KC, et al. Efficacy and safety of diphenylcyclopropenone among Chinese patients with steroid resistant and extensive alopecia areata. J Eur Acad Dermatol Venereol. 2013;27(3):e400–5.PubMedCrossRef
51.
Singh G, Okade R, Naik C, Dayanand CD. Diphenylcyclopropenone immunotherapy in ophiasis. Indian J Dermatol Venereol Leprol. 2007;73(6):432–3.PubMedCrossRef
52.
Sotiriadis D, Patsatsi A, Lazaridou E, Kastanis A, Vakirlis E, Chrysomallis F. Topical immunotherapy with diphenylcyclopropenone in the treatment of chronic extensive alopecia areata. Clin Exp Dermatol. 2007;32(1):48–51.PubMed
53.
Orecchia G, Malagoli P. Topical immunotherapy in children with alopecia areata. J Invest Dermatol. 1995;104(5 Suppl):35S-36S.PubMedCrossRef
54.
Durdu M, Özcan D, Baba M, Seçkin D. Efficacy and safety of diphenylcyclopropenone alone or in combination with anthralin in the treatment of chronic extensive alopecia areata: a retrospective case series. J Am Acad Dermatol. 2015;72(4):640–50.PubMedCrossRef
55.
Özdemir M, Balevi A. Bilateral half-head comparison of 1% anthralin ointment in children with alopecia areata. Pediatr Dermatol. 2017;34(2):128–32.PubMedCrossRef
56.
Wu SZ, Wang S, Ratnaparkhi R, Bergfeld WF. Treatment of pediatric alopecia areata with anthralin: a retrospective study of 37 patients. Pediatr Dermatol. 2018;35(6):817–20.PubMedCrossRef
57.
Torchia D, Schachner LA. Bilateral treatment for alopecia areata. Pediatr Dermatol. 2010;27(4):415–6.PubMedCrossRef
58.
Letada PR, Sparling JD, Norwood C. Imiquimod in the treatment of alopecia universalis. Cutis. 2007;79(2):138–40.PubMed
59.
Wasyłyszyn T, Borowska K. Possible advantage of imiquimod and diphenylcyclopropenone combined treatment versus diphenylcyclopropenone alone: an observational study of nonresponder patients with alopecia areata. Austral J Dermatol. 2017;58(3):219–23.CrossRef
60.
61.
Talpur R, Vu J, Bassett R, Stevens V, Duvic M. Phase I/II randomized bilateral half-head comparison of topical bexarotene 1% gel for alopecia areata. J Am Acad Dermatol. 2009;61(4):592.e1-592.e5929.PubMedCrossRef
62.
Jun M, Lee NR, Lee WS. Efficacy and safety of superficial cryotherapy for alopecia areata: A retrospective, comprehensive review of 353 cases over 22 years [published correction appears in J Dermatol. 2017 Aug;44(8):985]. J Dermatol. 2017;44(4):386–93.
63.
Zawar VP, Karad GM. Liquid nitrogen cryotherapy in recalcitrant alopecia areata: a study of 11 patients. Int J Trichol. 2016;8(1):15–20.CrossRef
64.
Jury CS, McHenry P, Burden AD, Lever R, Bilsland D. Narrowband ultraviolet B (UVB) phototherapy in children. Clin Exp Dermatol. 2006;31(2):196–9.PubMedCrossRef
65.
Al-Mutairi N. 308-nm excimer laser for the treatment of alopecia areata in children. Pediatr Dermatol. 2009;26(5):547–50.PubMedCrossRef
66.
Al-Mutairi N. 308-nm excimer laser for the treatment of alopecia areata. Dermatol Surg. 2007;33(12):1483–7.PubMedCrossRef
67.
Zakaria W, Passeron T, Ostovari N, Lacour JP, Ortonne JP. 308-nm excimer laser therapy in alopecia areata. J Am Acad Dermatol. 2004;51(5):837–8.PubMedCrossRef
68.
Cho HR, Lew BL, Lew H, Sim WY. Treatment effects of intradermal botulinum toxin type A injection on alopecia areata. Dermatol Surg. 2010;36(Suppl 4):2175–81.PubMedCrossRef
69.
70.
Jahn-Bassler K, Bauer WM, Karlhofer F, Vossen MG, Stingl G. Sequential high- and low-dose systemic corticosteroid therapy for severe childhood alopecia areata. J Dtsch Dermatol Ges. 2017;15(1):42–7.PubMedCrossRef
71.
Lalosevic J, Gajic-Veljic M, Bonaci-Nikolic B, Nikolic M. Combined oral pulse and topical corticosteroid therapy for severe alopecia areata in children: a long-term follow-up study. Dermatol Ther. 2015;28(5):309–17.PubMedCrossRef
72.
Chong JH, Taïeb A, Morice-Picard F, Dutkiewicz AS, Léauté-Labrèze C, Boralevi F. High-dose pulsed corticosteroid therapy combined with methotrexate for severe alopecia areata of childhood. J Eur Acad Dermatol Venereol. 2017;31(11):e476–7.PubMedCrossRef
73.
Seiter S, Ugurel S, Tilgen W, Reinhold U. High-dose pulse corticosteroid therapy in the treatment of severe alopecia areata. Dermatology. 2001;202(3):230–4.PubMedCrossRef
74.
Unger WP, Schemmer RJ. Corticosteroids in the treatment of alopecia totalis. Systemic effects. Arch Dermatol. 1978;114(10):1486–90.PubMedCrossRef
75.
Sharma VK, Gupta S. Twice weekly 5 mg dexamethasone oral pulse in the treatment of extensive alopecia areata. J Dermatol. 1999;26(9):562–5.PubMedCrossRef
76.
Smith A, Trüeb RM, Theiler M, Hauser V, Weibel L. High relapse rates despite early intervention with intravenous methylprednisolone pulse therapy for severe childhood alopecia areata. Pediatr Dermatol. 2015;32(4):481–7.PubMedCrossRef
77.
Senila SC, Danescu SA, Ungureanu L, Candrea E, Cosgarea RM. Intravenous methylprednisolone pulse therapy in severe alopecia areata. Indian J Dermatol Venereol Leprol. 2015;81(1):95.PubMedCrossRef
78.
Hubiche T, Léauté-Labrèze C, Taïeb A, Boralevi F. Poor long term outcome of severe alopecia areata in children treated with high dose pulse corticosteroid therapy. Br J Dermatol. 2008;158(5):1136–7.PubMedCrossRef
79.
Bin Saif GA. Oral mega pulse methylprednisolone in alopecia universalis. Saudi Med J. 2006;27(5):717–20.PubMed
80.
Friedli A, Labarthe MP, Engelhardt E, Feldmann R, Salomon D, Saurat JH. Pulse methylprednisolone therapy for severe alopecia areata: an open prospective study of 45 patients. J Am Acad Dermatol. 1998;39(4 Pt 1):597–602.PubMedCrossRef
81.
Kiesch N, Stene JJ, Goens J, Vanhooteghem O, Song M. Pulse steroid therapy for children’s severe alopecia areata? Dermatology. 1997;194(4):395–7.PubMedCrossRef
82.
Perriard-Wolfensberger J, Pasche-Koo F, Mainetti C, Labarthe MP, Salomon D, Saurat JH. Pulse of methylprednisolone in alopecia areata. Dermatology. 1993;187(4):282–5.PubMedCrossRef
83.
Kar BR, Handa S, Dogra S, Kumar B. Placebo-controlled oral pulse prednisolone therapy in alopecia areata. J Am Acad Dermatol. 2005;52(2):287–90.PubMedCrossRef
84.
85.
Sharma VK, Muralidhar S. Treatment of widespread alopecia areata in young patients with monthly oral corticosteroid pulse. Pediatr Dermatol. 1998;15(4):313–7.PubMedCrossRef
86.
Winter RJ, Kern F, Blizzard RM. Prednisone therapy for alopecia areata. A follow-up report. Arch Dermatol. 1976;112(11):1549–52.PubMedCrossRef
87.
Friedland R, Tal R, Lapidoth M, Zvulunov A, Ben AD. Pulse corticosteroid therapy for alopecia areata in children: a retrospective study. Dermatology. 2013;227(1):37–44.PubMedCrossRef
88.
Yoshimasu T, Kanazawa N, Yamamoto Y, Furukawa F. Multiple courses of pulse corticosteroid therapy for alopecia areata. J Dermatol. 2016;43(9):1075–7.PubMedCrossRef
89.
Alabdulkareem AS, Abahussein AA, Okoro A. Severe alopecia areata treated with systemic corticosteroids. Int J Dermatol. 1998;37(8):622–4.PubMedCrossRef
90.
Seo J, Lee YI, Hwang S, Zheng Z, Kim DY. Intramuscular triamcinolone acetonide: an undervalued option for refractory alopecia areata. J Dermatol. 2017;44(2):173–9.PubMedCrossRef
91.
Michalowski R, Kuczyńska L. Long-term intramuscular triamcinolone-acetonide therapy in alopecia areata totalis and universalis. Arch Dermatol Res. 1978;261(1):73–6.PubMedCrossRef
92.
Royer M, Bodemer C, Vabres P, et al. Efficacy and tolerability of methotrexate in severe childhood alopecia areata. Br J Dermatol. 2011;165(2):407–10.PubMedCrossRef
93.
Lucas P, Bodemer C, Barbarot S, Vabres P, Royer M, Mazereeuw-Hautier J. Methotrexate in severe childhood alopecia areata: long-term follow-up. Acta Derm Venereol. 2016;96(1):102–3.PubMedCrossRef
94.
Landis ET, Pichardo-Geisinger RO. Methotrexate for the treatment of pediatric alopecia areata. J Dermatol Treat. 2018;29(2):145–8.CrossRef
95.
Batalla A, Flórez Á, Abalde T, Vázquez-Veiga H. Methotrexate in alopecia areata: a report of three cases. Int J Trichol. 2016;8(4):188–90.CrossRef
96.
Siegfried EC, Arkin LM, Chiu YE, Hebert AA, Callen JP, Castelo-Soccio L, Co DO, Cordoro KM, Curran ML, Dalrymple AM, Flohr C, Gordon KB, Hanna D, Irvine AD, Kim S, Kirkorian AY, Lara-Corrales I, Lindstrom J, Paller AS, Reyes M, Begolka WS, Tom WL, Van Voorhees AS, Vleugels RA, Lee LW, Davies OMT, Brandling-Bennett HA. Methotrexate for inflammatory skin disease in pediatric patients: consensus treatment guidelines. Pediatr Dermatol. 2023;40(5):789–808. https://​doi.​org/​10.​1111/​pde.​15327. (Epub 2023 Jun 14).CrossRefPubMed
97.
Fiedler-Weiss VC, Rumsfield J, Buys CM, West DP, Wendrow A. Evaluation of oral minoxidil in the treatment of alopecia areata. Arch Dermatol. 1987;123(11):1488–90.PubMedCrossRef
98.
Vañó-Galván S, Pirmez R, Hermosa-Gelbard A, Moreno-Arrones ÓM, Saceda-Corralo D, Rodrigues-Barata R, Jimenez-Cauhe J, Koh WL, Poa JE, Jerjen R, Trindade de Carvalho L, John JM, Salas-Callo CI, Vincenzi C, Yin L, Lo-Sicco K, Waskiel-Burnat A, Starace M, Zamorano JL, Jaén-Olasolo P, Piraccini BM, Rudnicka L, Shapiro J, Tosti A, Sinclair R, Bhoyrul B. Safety of low-dose oral minoxidil for hair loss: a multicenter study of 1404 patients. J Am Acad Dermatol. 2021;84(6):1644-1651. https://​doi.​org/​10.​1016/​j.​jaad.​2021.​02.​054. Epub 2021 Feb 24.
99.
100.
101.
102.
King B, Zhang X, Harcha WG, et al. Efficacy and safety of ritlecitinib in adults and adolescents with alopecia areata: a randomised, double-blind, multicentre, phase 2b-3 trial [published correction appears in Lancet. 2023 Jun 10;401(10392):1928]. Lancet. 2023;401(10387):1518–29.
103.
Hordinsky M, Hebert AA, Gooderham M, Kwon O, Murashkin N, Fang H, Harada K, Law E, Wajsbrot D, Takiya L, Zwillich SH, Wolk R, Tran H. Efficacy and safety of ritlecitinib in adolescents with alopecia areata: Results from the ALLEGRO phase 2b/3 randomized, double-blind, placebo-controlled trial. Pediatr Dermatol. 2023. https://​doi.​org/​10.​1111/​pde.​15378. (Epub ahead of print).CrossRefPubMed
104.
Jabbari A, Dai Z, Xing L, et al. Reversal of alopecia areata following treatment with the JAK1/2 Inhibitor baricitinib. EBioMedicine. 2015;2(4):351–5 (Published 2015 Feb 26).PubMedPubMedCentralCrossRef
105.
Craiglow BG, Liu LY, King BA. Tofacitinib for the treatment of alopecia areata and variants in adolescents. J Am Acad Dermatol. 2017;76(1):29–32.PubMedCrossRef
106.
Castelo-Soccio L. Experience with oral tofacitinib in 8 adolescent patients with alopecia universalis. J Am Acad Dermatol. 2017;76(4):754–5.PubMedCrossRef
107.
Kibbie J, Kines K, Norris D, Dunnick CA. Oral tofacitinib for the treatment of alopecia areata in pediatric patients. Pediatr Dermatol. 2022;39(1):31–4.PubMedCrossRef
108.
Craiglow BG, King BA. Tofacitinib for the treatment of alopecia areata in preadolescent children. J Am Acad Dermatol. 2019;80(2):568–70.PubMedCrossRef
109.
Dai YX, Chen CC. Tofacitinib therapy for children with severe alopecia areata. J Am Acad Dermatol. 2019;80(4):1164–6.PubMedCrossRef
110.
Brown L, Skopit S. An excellent response to tofacitinib in a pediatric alopecia patient: a case report and review. J Drugs Dermatol. 2018;17(8):914–7.PubMed
111.
Patel NU, Oussedik E, Grammenos A, Pichardo-Geisinger R. A case report highlighting the effective treatment of alopecia universalis with tofacitinib in an adolescent and adult patient. J Cutan Med Surg. 2018;22(4):439–42.PubMedCrossRef
112.
Liu LY, King BA. Response to tofacitinib therapy of eyebrows and eyelashes in alopecia areata. J Am Acad Dermatol. 2019;80(6):1778–9.PubMedCrossRef
113.
Berbert Ferreira R, Ferreira SB, Scheinberg MA. An excellent response to tofacitinib in a Brazilian adolescent patient with alopecia areata: a case report and a review of the literature. Clin Case Rep. 2019;7(12):2539–42 (Published 2019 Nov 21).PubMedPubMedCentralCrossRef
114.
Dincer Rota D, Emeksiz MAC, Erdogan FG, Yildirim D. Experience with oral tofacitinib in severe alopecia areata with different clinical responses. J Cosmet Dermatol. 2021;20(9):3026–33.PubMedCrossRef
115.
Jerjen R, Meah N, de Carvalho LT, Wall D, Eisman S, Sinclair R. Treatment of alopecia areata in pre-adolescent children with oral tofacitinib: a retrospective study. Pediatr Dermatol. 2021;38(1):103–8.PubMedCrossRef
116.
Akdogan N, Ersoy-Evans S, Doğan S, Atakan N. Experience with oral tofacitinib in two adolescents and seven adults with alopecia areata. Dermatol Ther. 2019;32(6): e13118.PubMedCrossRef
117.
Liu LY, King BA. Ruxolitinib for the treatment of severe alopecia areata. J Am Acad Dermatol. 2019;80(2):566–8.PubMedCrossRef
118.
McKenzie PL, Castelo-Soccio L. Dupilumab therapy for alopecia areata in pediatric patients with concomitant atopic dermatitis. J Am Acad Dermatol. 2021;84(6):1691–4.PubMedCrossRef
119.
120.
Aleisa A, Lim Y, Gordon S, et al. Response to ustekinumab in three pediatric patients with alopecia areata. Pediatr Dermatol. 2019;36(1):e44–5.PubMedCrossRef
121.
Skurkovich S, Korotky NG, Sharova NM, Skurkovich B. Treatment of alopecia areata with anti-interferon-gamma antibodies. J Investig Dermatol Symp Proc. 2005;10(3):283–4.PubMedCrossRef
122.
Liu LY, King BA. Lack of efficacy of apremilast in 9 patients with severe alopecia areata. J Am Acad Dermatol. 2017;77(4):773–4.PubMedCrossRef
123.
Kim BJ, Min SU, Park KY, et al. Combination therapy of cyclosporine and methylprednisolone on severe alopecia areata. J Dermatolog Treat. 2008;19(4):216–20.PubMedCrossRef
124.
Gensure RC. Clinical response to combined therapy of cyclosporine and prednisone. J Investig Dermatol Symp Proc. 2013;16(1):S58.PubMedCrossRef
125.
Farhangian ME, McMichael AJ, Huang KE, Feldman SR. Treatment of alopecia areata in the United States: a retrospective cross-sectional study. J Drugs Dermatol. 2015;14(9):1012–4.PubMed
126.
Price VH, Willey A, Chen BK. Topical tacrolimus in alopecia areata. J Am Acad Dermatol. 2005;52(1):138–9.PubMedCrossRef
127.
Thiers BH. Topical tacrolimus: treatment failure in a patient with alopecia areata. Arch Dermatol. 2000;136(1):124.PubMedCrossRef
128.
Jung KE, Gye JW, Park MK, Park BC. Comparison of the topical FK506 and clobetasol propionate as first-line therapy in the treatment of early alopecia areata. Int J Dermatol. 2017;56(12):1487–8.PubMedCrossRef
129.
Sauerbrey A. Successful immunsuppression in childhood alopecia areata. Klin Padiatr. 2011;223(4):244–5.PubMedCrossRef
130.
Rashidi T, Mahd AA. Treatment of persistent alopecia areata with sulfasalazine. Int J Dermatol. 2008;47(8):850–2.PubMedCrossRef
131.
Bakar O, Gurbuz O. Is there a role for sulfasalazine in the treatment of alopecia areata? J Am Acad Dermatol. 2007;57(4):703–6.PubMedCrossRef
132.
Aghaei S. An uncontrolled, open label study of sulfasalazine in severe alopecia areata. Indian J Dermatol Venereol Leprol. 2008;74(6):611–3.PubMedCrossRef
133.
Yun D, Silverberg NB, Stein SL. Alopecia areata treated with hydroxychloroquine: a retrospective study of nine pediatric cases. Pediatr Dermatol. 2018;35(3):361–5.PubMedCrossRef
134.
Mitchell AJ, Douglass MC. Topical photochemotherapy for alopecia areata. J Am Acad Dermatol. 1985;12(4):644–9.PubMedCrossRef
135.
Majumdar B, De A, Ghosh S, et al. “Turban PUVAsol:” a simple, novel, effective, and safe treatment option for advanced and refractory cases of alopecia areata. Int J Trichol. 2018;10(3):124–8.CrossRef
136.
Yoon TY, Kim YG. Infant alopecia universalis: role of topical PUVA (psoralen ultraviolet A) radiation. Int J Dermatol. 2005;44(12):1065–7.PubMedCrossRef
137.
138.
El-Mofty M, Rasheed H, El-Eishy N, et al. A clinical and immunological study of phototoxic regimen of ultraviolet A for treatment of alopecia areata: a randomized controlled clinical trial. J Dermatol Treat. 2019;30(6):582–7.CrossRef
139.
140.
Boonyaleepun S, Boonyaleepun C, Schlactus JL. Effect of IVIG on the hair regrowth in a common variable immune deficiency patient with alopecia universalis. Asian Pac J Allergy Immunol. 1999;17(1):59–62.PubMed
141.
Teshima H, Sogawa H, Mizobe K, Kuroki N, Nakagawa T. Application of psychoimmunotherapy in patients with alopecia universalis. Psychother Psychosom. 1991;56(4):235–41.PubMedCrossRef
142.
Toma DM, Atallah RB, Eldahshan RM. Comparative study between topical methotrexate 1% gel and minoxidil 5% gel in the treatment of localized alopecia areata. Dermatol Ther. 2022;35(9): e15696.PubMedCrossRef
143.
Anuset D, Perceau G, Bernard P, Reguiai Z. Efficacy and safety of methotrexate combined with low- to moderate-dose corticosteroids for severe alopecia areata. Dermatology. 2016;232(2):242–8.PubMedCrossRef
144.
145.
Droitcourt C, Milpied B, Ezzedine K, et al. Interest of high-dose pulse corticosteroid therapy combined with methotrexate for severe alopecia areata: a retrospective case series. Dermatology. 2012;224(4):369–73.PubMedCrossRef
146.
Olsen EA, Carson SC, Turney EA. Systemic steroids with or without 2% topical minoxidil in the treatment of alopecia areata. Arch Dermatol. 1992;128(11):1467–73.PubMedCrossRef
147.
Sethuraman G, Malhotra AK, Sharma VK. Alopecia universalis in Down syndrome: response to therapy. Indian J Dermatol Venereol Leprol. 2006;72(6):454–5.PubMedCrossRef
148.
Kiszewski AE, Bevilaqua M, De Abreu LB. Mesalazine in the treatment of extensive alopecia areata: a new therapeutic option? Int J Trichology. 2018;10(3):99–102.PubMedPubMedCentralCrossRef
149.
Sardana K, Gupta A, Gautam RK. Recalcitrant alopecia areata responsive to leflunomide and anthralin-Potentially undiscovered JAK/STAT inhibitors? Pediatr Dermatol. 2018;35(6):856–8.PubMedCrossRef
150.
Das S, Ghorami RC, Chatterjee T, Banerjee G. Comparative assessment of topical steroids, topical tretenoin (0.05%) and dithranol paste in alopecia areata. Indian J Dermatol. 2010;55(2):148–9.PubMedPubMedCentralCrossRef
151.
152.
Mahgoub D, Mohye Eldeen R, Saadi D, El-Samanoudy S, Ibrahim S. Clinical and trichoscopic evaluation of trichloroacetic acid 35% vs phenol 88% peels in treatment of alopecia areata. J Cosmet Dermatol. 2021;20(1):143–9.PubMedCrossRef
153.
Camacho FM, García-Hernández MJ. Zinc aspartate, biotin, and clobetasol propionate in the treatment of alopecia areata in childhood. Pediatr Dermatol. 1999;16(4):336–8.PubMedCrossRef
154.
Lux-Battistelli C. Combination therapy with zinc gluconate and PUVA for alopecia areata totalis: an adjunctive but crucial role of zinc supplementation. Dermatol Ther. 2015;28(4):235–8.PubMedCrossRef
155.
Fenniche S, Hammami H, Zaouak A. Association of khellin and 308-nm excimer lamp in the treatment of severe alopecia areata in a child. J Cosmet Laser Ther. 2018;20(3):156–8.PubMedCrossRef
156.
Metadata
Title
Treatment Options for Alopecia Areata in Children and Adolescents
Authors
Linnea L. Westerkam
Diana B. McShane
Elizabeth L. Nieman
Dean S. Morrell
Publication date
11-03-2024
Publisher
Springer International Publishing
Published in
Pediatric Drugs / Issue 3/2024
Print ISSN: 1174-5878
Electronic ISSN: 1179-2019
DOI
https://doi.org/10.1007/s40272-024-00620-2

Other articles of this Issue 3/2024

Pediatric Drugs 3/2024 Go to the issue

Review Article

Neonatal Necrotizing Enterocolitis: An Update on Pathophysiology, Treatment, and Prevention

Review Article

Perforated appendicitis: room for improvement?

Original Research Article

Comparison of Deep and Moderate Neuromuscular Blockade for Major Laparoscopic Surgery in Children: A Randomized Controlled Trial

Systematic Review

Dapagliflozin and Empagliflozin in Paediatric Indications: A Systematic Review

Original Research Article

The Effect of Polymorphisms and Other Biomarkers on Infliximab Exposure in Paediatric Inflammatory Bowel Disease: Development of a Population Pharmacokinetic Model

Original Research Article

Improving Methylphenidate Titration in Children with Attention-Deficit/Hyperactivity Disorder (ADHD): A Randomized Controlled Trial Using Placebo-Controlled Titration Implemented in Clinical Practice