Epidemiology, Diagnosis and Management of Alopecia Areata: An Asia-Pacific Modified Delphi Expert Panel Recommendations
Issued Date
2026-01-01
Resource Type
ISSN
00119059
eISSN
13654632
Scopus ID
2-s2.0-105030286510
Pubmed ID
41699409
Journal Title
International Journal of Dermatology
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Dermatology (2026)
Suggested Citation
Sinclair R., Yang C.C., Chung W.H., Dhurat R., Ganjoo A., Khunkhet S., Lin J., Parthasaradhi A., Shin H.T., Shin K., Suchonwanit P., Tan K.T., Tang J.J., Wu W., Yap F.B.B., Yip L., Yong A., Zhou C. Epidemiology, Diagnosis and Management of Alopecia Areata: An Asia-Pacific Modified Delphi Expert Panel Recommendations. International Journal of Dermatology (2026). doi:10.1111/ijd.70335 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/115242
Title
Epidemiology, Diagnosis and Management of Alopecia Areata: An Asia-Pacific Modified Delphi Expert Panel Recommendations
Author's Affiliation
Fudan University
National Cheng Kung University
Chang Gung Memorial Hospital
Peking University People's Hospital
Universiti Tunku Abdul Rahman
Medical School of Pusan National University
Ramathibodi Hospital
Pusan National University Yangsan Hospital
Melbourne Medical School
Inha University Hospital
Lokmanya Tilak Municipal General Hospital
Mount Elizabeth Medical Centre
Hospital Raja Permaisuri Bainun
Gleneagles Hospital
Faculty of Medicine, Srinakharinwirot University
Sunway Medical Centre
Sinclair Dermatology
Anchala Skin Institute and Research Centre
Skin Partners Specialist Dermatologists
Skinnovation Clinics
National Cheng Kung University
Chang Gung Memorial Hospital
Peking University People's Hospital
Universiti Tunku Abdul Rahman
Medical School of Pusan National University
Ramathibodi Hospital
Pusan National University Yangsan Hospital
Melbourne Medical School
Inha University Hospital
Lokmanya Tilak Municipal General Hospital
Mount Elizabeth Medical Centre
Hospital Raja Permaisuri Bainun
Gleneagles Hospital
Faculty of Medicine, Srinakharinwirot University
Sunway Medical Centre
Sinclair Dermatology
Anchala Skin Institute and Research Centre
Skin Partners Specialist Dermatologists
Skinnovation Clinics
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Alopecia areata (AA) affects all ages, genders, and ethnicities. AA severely impacts patients' quality of life. Treatments indicated for AA have only been approved since 2022/2023. While some Asia Pacific (APAC) countries/regions have national or regional guidelines, many lack AA-specific guidance or have not updated existing guidelines to incorporate recently approved treatments. Methods: To better inform treatment decisions, 18 dermatologists from Australia, China, India, Korea, Malaysia, Singapore, Taiwan, and Thailand completed a three-round Delphi-based consensus process involving survey completion, open discussion, and statement voting. A consensus for Likert-type and multiple-choice statements was defined as ≥ 70% agreement or disagreement. Results: Consensus was achieved on 140 statements. The panel recognizes that AA is clinically heterogeneous and imposes a considerable burden on patients and their families. Trichoscopy is deemed essential for diagnosing and monitoring AA, while skin biopsy is reserved for when the cause of hair loss is unclear. In terms of disease severity, moderate AA is defined as 21%–49% hair loss and severe AA as ≥ 50% hair loss. Regarding treatment, topical corticosteroids are recommended in children < 12 years. For patients aged ≥ 12 years, topical and intralesional corticosteroids could be used for mild-to-moderate AA, while Janus kinase inhibitors and systemic corticosteroids have a role in moderate-to-severe AA. Adjuvant minoxidil could also be used in chronic AA. Conclusions: This modified Delphi-based consensus provides a practical, region-focused framework to standardize the diagnosis and management of AA across diverse APAC healthcare settings in hope of improving patient outcomes.