Surveys Show Differences in Patient, Clinician Perspectives on the Impact of Alopecia Areata

While patients and clinicians often share common goals with alopecia areata (AA) treatment, studies presented at Winter Clinical Miami 2026 highlighted discrepancies between clinician and patient priorities and a need for better communication to improve patient-centered care.^1,2

Alopecia areata (AA) is a systemic immune-mediated hair loss condition ranging in presentation from small scalp patches to complete loss of scalp and body hair.³ The lifetime risk of this condition is approximately 2%.⁴

The emergence of oral Janus kinase (JAK) inhibitors has transformed the treatment landscape for moderate-to-severe disease, leading to high patient satisfaction with treatment.¹ The posters presented at Winter Clinical Miami 2026 displayed research from 2 cross-sectional surveys of both clinicians and patients with AA across the US to offer a detailed look at how care is actually being delivered and experienced and where meaningful gaps between patients and clinicians remain.^1,2

Clinician Survey Highlights Goals of Rapid and Complete Hair Regrowth in AA

The first poster delved into a clinician survey that was conducted in May 2025.¹ In total, it enrolled 225 clinicians: 150 dermatologists, 50 advanced practice providers, and 25 primary care physicians, with an average of 13 years in practice. Clinicians rated the quality-of-life (QOL) impact of AA as highest in severe disease (mean score, 8.3 out of 10) compared with moderate (7.3) and mild (5.9) disease, using a scale where 10 represented complete interference.

Nearly 90% of respondents had prescribed an oral JAK inhibitor (JAKi) to treat AA, and on average, 21.5% of their patients with AA were currently taking one. Clinician-reported patient satisfaction with oral JAKi was strikingly high: more than 80% of clinicians treating patients with moderate-to-severe AA reported that those patients were satisfied with JAKi therapy. In contrast, satisfaction with non-JAKi therapies was below 40% for severe disease and below 60% for moderate disease. This gap underscores the perceived clinical value of these newer agents.

When ranking 10 treatment goals in order of importance, clinicians prioritized efficacy above all. "Seeing hair regrow to nearly complete (about three-quarters regrowth) as quickly as possible" received the highest average rank (3.8 out of 10, where 1 represents most important), closely followed by achieving the same level of regrowth within 6 to 12 months (mean rank, 4). Factors such as reduced monitoring burden, oral route of administration, and once-daily dosing ranked last.

Despite their confidence in JAKi and the reported high patient satisfaction, clinicians estimated that only about half of their patients were aware of these treatment options. Furthermore, only 15.6% believed their patients were "very aware." The authors note that this research “highlights an opportunity for improved patient education and shared decision-making.”

Patient Survey Emphasizes Safety of AA Treatment

The companion survey enrolled 522 adult patients with self-reported AA diagnoses, recruited through the National Alopecia Areata Foundation and the M3 Global Research panel. Respondents were predominantly female (72.4%) and averaged 49.5 years of age.² Nearly 40% characterized their current disease as severe and another 39% as moderate. While 92.9% expressed interest in medical treatment options, 63.2% had never taken a JAKi for AA.

On JAKi awareness, patients and clinicians diverged markedly. Among patients, 65.7% reported being at least somewhat aware of JAKi as a treatment option, with 35.8% describing themselves as "very aware." Clinicians underestimated this: only 53.8% believed their patients were somewhat or very aware, and just 15.6% said patients were very aware. A further gap emerged on communication: while 94.2% of clinicians reported keeping their AA patients updated on new treatment options, only 63.7% of patients seen within the prior 24 months agreed that their doctor did so.

Treatment goal priorities also differed between the groups. Patients ranked "finding a treatment with low risk of a rare but serious side effect, such as a serious infection, blood clot, or cancer" as their top priority (mean rank, 4.1). Clinicians ranked the same goal fifth (mean rank, 4.8), placing speed of regrowth above safety. Both groups agreed that factors like dosing frequency and oral administration were the least important considerations.

The gap in shared decision-making was similarly notable. Clinicians rated their own effectiveness in involving patients at 80.8 out of 100, while patients rated clinician involvement at only 69.1. This 11-point discrepancy suggests that clinicians overestimate how engaged patients feel in treatment discussions.

On QOL, patients with moderate AA reported a burden (mean score, 4.8) nearly equivalent to those with severe disease (4.6). This finding contrasts with the clinician-assigned scores, which showed a larger gap between moderate (7.3) and severe (8.3) disease. This suggests clinicians may underestimate the impact of moderate AA while overestimating that of severe disease relative to patients' own experience.

“New treatments for moderate-to-severe AA are transforming clinical practice by enhancing clinicians’ ability to better target the underlying immunopathogenic drivers of the disease,” the authors noted. “As the treatment landscape for AA continues to evolve rapidly, gaining insights into both patient and clinician perspectives is essential to optimize care and strengthen shared decision-making.”

References

1. Mesinkovska NA, Mostaghimi A, Mayorga V, et al. Landmark survey of clinician perspectives, preferences, and challenges in the care of alopecia areata. Poster presented at: Winter Clinical Miami 2026; February 27-March 1, 2026; Aventura, FL.

2. Mesinkovska NA, Mostaghimi A, Mayorga V, et al. Landmark survey of patient and clinician perspectives on the impact of alopecia areata and treatment priorities. Poster presented at: Winter Clinical Miami 2026; February 27-March 1, 2026; Aventura, FL.

3. Trüeb RM, Dias MFRG. Alopecia areata: a comprehensive review of pathogenesis and management. Clin Rev Allergy Immunol. 2018;54(1):68-87. doi:10.1007/s12016-017-8620-9

4. Mirzoyev SA, Schrum AG, Davis MDP, Torgerson RR. Lifetime incidence risk of alopecia areata estimated at 2.1% by Rochester Epidemiology Project, 1990-2009. J Invest Dermatol. 2014;134(4):1141-1142. doi:10.1038/jid.2013.464