What changed in 2025 for GPs, dermatologists and aesthetic doctors and nurses: the finasteride review, the BAD's alopecia areata guideline, and new rules for aesthetic practice.
From the editors
This edition looks back at 2025 from the consulting room. It is part of our Four years in review series, written in 2026, and each development is referenced to a regulator, guideline or journal.
For medical colleagues, 2025 brought two documents that changed conversations with patients. In May, the European Medicines Agency's safety committee confirmed suicidal thoughts as a side effect of finasteride. In November, the British Association of Dermatologists published its 2025 living guideline on alopecia areata, with a strong recommendation to offer licensed JAK inhibitors for severe disease.
For aesthetic doctors and nurses, the year was about the future shape of regulation, with plans for England and a Bill in Scotland. This edition sets out what was decided, what was only proposed, and what follows for safe, well-documented practice. It contains no dosing advice; prescribers should rely on the product information and current guidance.
The Trichollective editorial team
Guidance
The BAD's update made a clear recommendation on JAK inhibitors, and an equally clear one on the safety conversation that should come with them.
Photograph Jessica Felicio / Unsplash
Words by the Trichollective editorial team
The British Association of Dermatologists manages its alopecia areata guideline as a living document, updated as evidence emerges. The baseline iteration appeared in the February 2025 issue of the British Journal of Dermatology. The 2025 update was published online on 14 November 2025, based on literature surveillance up to 11 July 2025.
The update added eleven new recommendations and amended eleven others. The BAD also published supplementary guidance on ritlecitinib, developed with the British Hair and Nail Society and Alopecia UK. Ritlecitinib is the JAK inhibitor recommended by NICE for severe alopecia areata in people aged 12 and over.
“A clear recommendation to offer treatment, and an equally clear one on the safety conversation that should come with it.
Deuruxolitinib, a third JAK inhibitor for severe alopecia areata, had been approved in the United States in July 2024. An NIHR Innovation Observatory briefing in April 2025 recorded that it had no marketing authorisation in the UK or EU for any indication at that time.
The guideline's emphasis on psychological support reflects what patients report. The NIHR briefing notes a UK study finding higher rates of depression and anxiety in people with alopecia areata. Asking about mood is part of good care, whatever treatment is chosen.
Test yourself
According to the 2025 BAD guideline, how long may evaluation of response to a JAK inhibitor need to extend, case by case?
Sources
Every fact in this edition, and where it came from.
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Next · 2024 · Year in review
2024 in review
The year the evidence caught up.