Treat the Whole Patient: Enhancing Care in Pediatric Alopecia Areata

Understanding and treating pediatric alopecia areata (AA), and its impact on the emotional and social lives of children and young people, was the subject of a presentation by dermatologist Brittany Craiglow, MD, PhD, FAAD. 

Addressing an audience of dermatologists at the 2025 American Academy of Dermatology Annual Meeting, Dr. Craiglow, a double-board certified dermatologist practicing in Fairfield, CT, talked about the multifaceted nature of AA in children, highlighting the significant emotional and social challenges these patients face and the promising treatment options now available.

“Alopecia is more than just hair loss; it’s an issue of identity, self-worth, and social integration,” Dr. Craiglow said, emphasizing the psychological toll of the disease. “For children, alopecia isn’t cosmetic—it’s life-altering."

One of the key themes in Dr. Craiglow’s presentation was the evolution of treatment options for AA, which she described as “transformative.” Among the therapies discussed were oral minoxidil, JAK inhibitors, and dupilumab, each of which offers new hope for patients with this challenging condition.

Oral Minoxidil: Safe and Versatile
Dr. Craiglow pointed to the growing use of oral minoxidil, which has shown efficacy in promoting regrowth even in severe cases.

“Oral minoxidil is becoming a cornerstone for many patients with chronic hair loss,” she explained. She noted its role in stimulating eyebrow and eyelash regrowth in cases of extensive alopecia, particularly when combined with other treatments.

JAK Inhibitors: Game-Changer for Severe Alopecia
Dr. Craiglow also discussed the groundbreaking potential of JAK inhibitors like baricitinib for patients aged 12 and older. Sharing data from clinical trials, she emphasized the importance of early treatment, noting that patients with less than 95% hair loss responded significantly better.

“We shouldn’t wait until there’s no hair left,” she urged, adding that timely intervention can dramatically improve outcomes.

Holistic Assessments 
Beyond medical treatment, Dr. Craiglow advocated for a more comprehensive approach to assessing AA severity. While traditional scales like the SALT score focus solely on physical hair loss, Dr. Craiglow talked about the need to consider psychosocial factors, such as the emotional toll and social impact of the disease.

“There’s really no such thing as mild alopecia,” she said, urging practitioners to view even small patches of hair loss as serious (as their patients do).

Concluding her talk, Dr. Craiglow called on dermatologists to rethink the way they approach AA. 

“We now have tools to give these kids their lives back,” she said. “It’s up to us to treat this condition with the seriousness it deserves.”  -by Eric Raible

Source: Craiglow B. Presented at: 2025 AAD Annual Meeting, March 7-11, 2025; Orlando.