Although ritlecitinib has recently been approved for the treatment of severe alopecia areata, real-world data on its efficacy and tolerability remain limited. To address this gap, an Italian retrospective, observational study evaluated the efficacy and tolerability of ritlecitinib in 102 patients aged 12 years and older with severe alopecia areata. At week 24, ritlecitinib 50 mg/day resulted in a Severity of Alopecia Tool (SALT) score of ≤20 in 40.2% of patients, with a greater response observed in adolescents (48.6%) than in adults (21.9%). The mean SALT score decreased from 86.2 ± 18.5 to 40.8 ± 37.1.

Treatment was associated with significant improvements in both trichoscopic features and quality of life. Additionally, treatment was effective for eyebrow, eyelash, and nail involvement. Adverse events were generally mild, including acne and headache, with treatment discontinued in one…