Systemic Treatment of Moderate to Severe Alopecia Areata: 2025/26 Consensus

Abstract

This publication represents the unified voice of Australia’s leading hair specialists on the management of chronic hair loss. Dr Sharma and Dr Ghiya contributed to this update to incorporate the latest TGA-approved therapies, specifically Janus Kinase (JAK) inhibitors. The article is designed to bridge the gap between clinical research and patient care, outlining the exact criteria for when a patient should move from topical treatments to systemic therapy.

The consensus emphasises that "success" is defined not just by hair counts, but by the patient's quality of life. It provides a detailed safety monitoring protocol, making it an essential resource for patients who may be hesitant about the side effects of newer medications. For those seeking a transplant, this paper is highly relevant as it discusses the "stabilisation" phase—ensuring that the patient's underlying condition is controlled so that an FUE transplant can be performed on a healthy, stable foundation for permanent results.