Guidelines for the Management of Patients with Alopecia Areata in Korea: Part I Topical and Device-based Treatment

Hyunsun Park; Jung Eun Kim; Jee Woong Choi; Do Young Kim; Yong Hyun Jang; Young Lee; Jiehyun Jeon; Hyun-Tae Shin; Min Sung Kim; Jung Won Shin; Sung Bin Cho; Bark-Lynn Lew; Gwang Seong Choi

doi:10.5021/ad.22.168

Guidelines for the Management of Patients with Alopecia Areata in Korea: Part I Topical and Device-based Treatment

Ann Dermatol. 2023 Jun;35(3):190-204. doi: 10.5021/ad.22.168.

Authors

Hyunsun Park¹, Jung Eun Kim², Jee Woong Choi³, Do Young Kim⁴, Yong Hyun Jang⁵, Young Lee⁶, Jiehyun Jeon⁷, Hyun-Tae Shin⁸, Min Sung Kim⁹, Jung Won Shin¹⁰, Sung Bin Cho¹¹, Bark-Lynn Lew¹², Gwang Seong Choi⁸

Affiliations

¹ Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea.
² Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
³ Department of Dermatology, Ajou University School of Medicine, Suwon, Korea.
⁴ Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea.
⁵ Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Korea.
⁶ Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea.
⁷ Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Korea.
⁸ Department of Dermatology, Inha University School of Medicine, Incheon, Korea.
⁹ Department of Dermatology, School of Medicine, Chosun University, Gwangju, Korea.
¹⁰ Department of Dermatology, Seoul National University Bundang Hospital, Bundang, Korea.
¹¹ Yonsei Seran Dermatology and Laser Clinic, Seoul, Korea.
¹² Department of Dermatology, Kyung Hee University School of Medicine, Seoul, Korea. bellotte@hanmail.net.

Abstract

Background: Alopecia areata (AA) is a chronic disease with an unpredictable disease course and severe psychological impact.

Objective: To provide evidence- and consensus-based insights regarding the treatment of patients with AA in Korea.

Methods: We searched for relevant studies on the topical and device-based treatment of AA in the literature from inception until May 2021. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommendations. Hair experts from the Korean Hair Research Society (KHRS) voted on the statements, and an agreement of 75% or greater was considered as consensus.

Results: Currently, there remains a scarcity of topical treatments, which is supported by robust evidence from a number of high-quality randomized controlled trials. Current evidence supports the efficacy of topical corticosteroids, corticosteroid intralesional injection, and contact immunotherapy in AA patients. Topical corticosteroids and contact immunotherapy are recommended for pediatric AA. A consensus was achieved in 6 out of 14 (42.8%), and 1 out of 5 (20.0%) statements pertaining to topical and device-based treatments in AA, respectively. The expert consensus was from a single country, and the study may not cover all the treatments used.

Conclusion: The present study provides up-to-date, evidence-based treatment guidelines for AA based on the consensus reached among experts after considering regional healthcare circumstances, adding diversity to the previous guidelines.

Keywords: Alopecia areata; Device; Guideline; Korea; Therapeutics; Topical.

Grants and funding

Korean Hair Research Society/Korea