Upadacitinib Shows Strong Hair Regrowth in Alopecia Areata

Key Takeaways

• Upadacitinib demonstrated significant scalp and facial hair regrowth in adolescents and adults with severe alopecia areata.
• Higher response rates were observed in adolescents, including notably greater rates of complete regrowth.
• Safety findings were consistent with the known JAK inhibitor profile, with no new safety signals identified.

Upadacitinib demonstrated robust efficacy in both adolescents and adults with severe alopecia areata (AA), with particularly strong responses observed in younger patients, according to a subgroup analysis of two Phase 3 trials presented by Melinda Gooderham, MD, MSc, at the American Academy of Dermatology (AAD) 2026 Annual Meeting.

The analysis evaluated patients aged 12 to 63 years with severe AA (Severity of Alopecia Tool [SALT] score ≥50) treated with upadacitinib 15 mg or 30 mg once daily. At Week 24, significantly greater proportions of patients receiving upadacitinib achieved the primary endpoint of SALT ≤20 compared with placebo across both studies and age groups. 

Response rates were higher among adolescents than adults. In adolescents, up to 84.6% of patients receiving 30 mg achieved SALT ≤20, compared with approximately 51% to 53% of adults. Dr. Gooderham noted that “it actually looks like it works even better in adolescents,” potentially reflecting shorter disease duration.

Higher thresholds of response were also achieved. Complete scalp hair regrowth (SALT 0) occurred in up to 46.2% of adolescents compared with approximately 17% to 22% of adults receiving the 30 mg dose.

“The SALT 0 rate for adults was one in five, but for the adolescents, it was up to 50%,” Dr. Gooderham said.

Treatment effects extended beyond scalp hair. Significant improvements in eyebrow and eyelash regrowth were observed, with up to 100% of adolescents achieving eyebrow regrowth in one study cohort. Dr. Gooderham emphasized the clinical relevance of these outcomes, noting that “hair on your face actually serves a purpose; your eyelashes protect your eyeballs.”

Safety findings were consistent with prior studies. No new safety signals were identified, and no serious adverse events were reported in adolescents.