A retrospective look at 2023 across the cosmetic, clinical and medical fields: new medicines for alopecia areata, a licensing consultation for cosmetic procedures in England, and a quality mark for a trichology register.
From the editors
This edition looks back at 2023. Trichozette did not exist then, and neither did Trichollective, whose story begins at Whittlebury Hall in January 2026. These are not back issues. They are part of a retrospective series, Four years in review, in which we return to each of the last four years and ask a plain question: what actually changed for the people who look after hair and scalps?
For 2023 the answer is more than you might remember. A second oral medicine for severe alopecia areata was approved in the United States, then in Europe and the UK, while the health technology bodies in England and Scotland declined to fund an earlier one. The government in England opened a consultation on licensing non-surgical cosmetic procedures. Advertising regulators turned their attention to hair transplant clinics. And in December, the Institute of Trichologists' register was accredited by the Professional Standards Authority.
None of these stories stayed in one lane. A licensing proposal written for injectables named scalp treatments too. A medicine approved for dermatologists changed what clients asked their stylists. A register accreditation changed how trichologists could describe themselves. That is why this edition gives each change three readings, one from each discipline.
Every factual claim in this volume comes from a source we have listed at the end. Where we could not verify something, we left it out. Where a story continued into later years, we say so and stop at the edge of 2023. The three field editions that follow go deeper into the cosmetic, clinical and medical detail.
The Trichollective editorial team
The year
New medicines, new rules and a new mark of assurance. How 2023 changed the ground under all three disciplines.
Photograph Jessica Felicio / Unsplash
Words by the Trichollective editorial team
Some years are remembered for a single headline. 2023 was different: several slow-moving stories reached a turning point at roughly the same time, and each of them touched more than one discipline. Taken together they explain a good deal about how hair and scalp care looks today.
On 23 June 2023 the US Food and Drug Administration approved ritlecitinib for severe alopecia areata in people aged 12 and over, the first treatment approved there for adolescents with the condition. The European Commission followed in September, and the MHRA authorised it for the UK in the autumn. Meanwhile, the funding bodies took a harder look at baricitinib, an earlier medicine in the same class. The Scottish Medicines Consortium did not accept it for severe alopecia areata in August, and NICE did not recommend it in October, in both cases because the cost-effectiveness case was uncertain.
In April the MHRA had also issued new safety measures for several JAK inhibitors used in chronic inflammatory conditions. The lesson for everyone was that these medicines are serious, specialist treatments, and not a quick fix to be promised in a salon.
On 2 September the Department of Health and Social Care opened a consultation on a licensing scheme for non-surgical cosmetic procedures in England, to be run by local authorities. It proposed sorting procedures into green, amber and red categories by risk, and a minimum client age of 18. Microneedling and micropigmentation appeared in the green list, platelet-rich plasma therapy in amber and hair restoration surgery in red.
“Several slow-moving stories reached a turning point at roughly the same time.
On 14 December the Professional Standards Authority accredited the register held by the Institute of Trichologists, with conditions. Accreditation is voluntary assurance of a register's standards, not statutory regulation: trichology is still not statutorily regulated in the UK or Ireland. But it gave the public a clearer way to check a practitioner's standing.
The pages that follow take each story in turn, starting with how the three disciplines saw the same year from their own chairs.
Sources
Every fact in this edition, and where it came from.
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Next · 2023 · Cosmetic
Cosmetic, 2023
Licences, labels and honest adverts.