What changed in 2026 for GPs, dermatologists and aesthetic doctors and nurses: a second NHS medicine for severe alopecia areata, strengthened finasteride warnings, new evidence on GLP-1 medicines and hair, and tighter oversight of injectables.
From the editors
This edition looks back at 2026 from the medical side of hair and scalp care. It is part of Four years in review, a retrospective series published on 30 September 2026. Trichozette is new, so this is a single account of the year rather than a collection of earlier issues, and the sources behind every claim are listed at the end.
For clinicians, 2026 was a year of more choice and more caution. Adults with severe alopecia areata gained a second NICE-recommended medicine. Product information for finasteride and dutasteride was strengthened. A large observational study added hair loss to the conversations worth having when GLP-1 treatment begins. In aesthetics, Scotland legislated, and doctors in Ireland called for safeguards on injectables.
Many of the people who first raise these concerns will not be in your consulting room. They will be at the salon basin or in a trichology clinic. The value of a community like ours is that those conversations reach you sooner and better described.
This edition does not give doses or treatment protocols. It sets out what changed, where to read the primary guidance and how the other two disciplines are likely to meet the same patients.
The Trichollective editorial team
Alopecia areata
Deuruxolitinib was licensed in March and recommended by NICE in July. What changed, what an audit found about ritlecitinib, and what the US did for adolescents.
Photograph Anastasiya Badun / Unsplash
Words by the Trichollective editorial team
Until 2024 there was no NICE-recommended medicine for severe alopecia areata. By the end of July 2026 there were two. For a condition that carries a heavy psychological burden and that many patients have been told cannot be treated, that is a real shift, and one that primary care needs to know about.
On 17 March 2026 the MHRA approved deuruxolitinib, an oral JAK inhibitor, for adults with severe alopecia areata. The approval rested on the THRIVE-AA1 and THRIVE-AA2 phase 3 trials, which together enrolled 1,223 people aged 18 to 65 with at least 50% scalp hair loss lasting more than six months. The most common side effects reported in at least 5% of patients were headache, acne and raised creatine phosphokinase.
NICE published final guidance, TA1178, on 15 July 2026, recommending deuruxolitinib for adults with severe alopecia areata, including alopecia totalis and universalis. Alopecia UK reported that eligible patients in England and Wales should be able to discuss it with specialist dermatology teams from mid-August, though local implementation may vary, and that the Scottish Medicines Consortium had not yet decided. Ritlecitinib, recommended by NICE in 2024, remains the other option.
An audit presented in the British Journal of Dermatology in June examined ritlecitinib prescribing across six regional dermatology centres. It found prescribing largely aligned with national guidance, but identified room to improve psychological assessment and the consistent use of severity scoring at the points where decisions to continue are made.
“By the end of July 2026 there were two.
On 28 September the US FDA approved baricitinib for people aged 12 and over with severe alopecia areata, based on the BRAVE-AA-PEDS trial. It is the second JAK inhibitor available to adolescents in the US, after ritlecitinib. The decision does not change UK licensing, and the medicine carries a boxed warning in the US covering serious infections, mortality, malignancy, major cardiovascular events and thrombosis.
What did the June 2026 audit suggest services could do better?
Sources
Every fact in this edition, and where it came from.
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Next · 2025 · Year in review
2025 in review
The year the rules caught up.