Should I recommend topical or systemic treatment?

For localized and limited hair loss, first-line treatment usually involves the use of corticosteroids, which are administered in topical formulations and/or as intralesional injections. Topical minoxidil is another treatment option validated in clinical trials that has been shown to be effective in promoting hair growth in alopecia areata. Among systemic treatment options, oral prednisolone remains a standard choice, but in recent years, oral Janus kinase inhibitors (e.g., baricitinib, ritlecitinib) have significantly expanded the therapeutic arsenal.