Jak inhibitors in the treatment of alopecia areata - a literature review

Abstract

Introduction
Alopecia areata (AA) is a chronic autoimmune disorder causing non-scarring hair loss, which can range from isolated patches to complete scalp (alopecia totalis, AT) or body hair loss (alopecia universalis, AU). It affects people of all ages, genders, and ethnicities. Around 10-20% of cases have a familial component, indicating a genetic predisposition. Symptoms often begin before age 40, with about half of patients experiencing onset in childhood, and it may coexist with other autoimmune diseases. The disease’s course is unpredictable, with spontaneous hair regrowth possible, though relapses are common, reaching a 100% relapse rate after 10-20 years. AA significantly affects quality of life, increasing the risk of anxiety and depression. Research has linked AA to autoimmune processes involving the JAK-STAT pathway, which promotes inflammation around hair follicles. Recent studies highlight the potential of JAK inhibitors as effective treatments.

Material and methods

An electronic literature search was performed using PubMed, Cochrane Library, and Evidence‑Based Medicine Reviews. Search terms included ‘alopecia areata’, ‘hair loss‘ , ‘JAK inhibitor’, ‘JAK-2 inhibitors’, ‘ Janus Kinase Inhibitors‘, ‘tofacitinib’, ruxolitinib’, ‘baricitinib’ as keywords. The review focused on articles published in English from their inception until 2025.

Conclusions

Janus kinase (JAK) inhibitors represent a significant advancement in treating alopecia areata by specifically targeting the JAK/STAT pathway, which is linked to hair loss. Oral JAK inhibitors like have shown the most promising results. However, challenges remain, including the risk of relapse after therapy, side effects, and limited efficacy of topical formulations. Ongoing research aims to develop more selective JAK inhibitors and maintenance strategies while addressing high treatment costs.