Alopecia UK is delighted to learn of the decision made by the Scottish Medicines Consortium (SMC) to accept the JAK inhibitor medicine ritlecitinib (Litfulo) for routine use within NHSScotland, for the treatment of severe alopecia areata* in patients aged 12 and over.

This news follows the recent decision by NICE to recommend ritlecitinib for routine NHS commissioning in England. It is the first time that the SMC has accepted a licensed treatment for routine use by NHSScotland for severe alopecia areata. You can find the SMC's final guidance here

Alopecia UK played a key role in advocating for this decision, making our own submission to the SMC appraisal process, capturing and sharing the experiences of patients and carers to show the significant impacts of alopecia areata, an autoimmune hair loss disease that affects people of all age groups and ethnicities. We are grateful to those in our community from Scotland who shared their views in the patient survey we shared in 2023.

Ritlecitinib is manufactured by pharmaceutical company Pfizer under the brand name Litfulo.  Evidence from clinical trials showed nearly 25% of adults and adolescents taking ritlecitinib (Litfulo) saw significant hair regrowth that covered 80% or more of their scalp after 24 weeks (vs 1.6% taking a placebo). After almost a year, the number of patients achieving a response increased further, with over 40% of patients achieving 80% or more scalp hair regrowth.

Alopecia UK CEO Sue Schilling says:

“It is great news that the SMC have made the decision to accept ritlecitinib (Litfulo) for use by NHSScotland. Since the NICE announcement in February, Alopecia UK has been inundated with enquiries from people right across the UK, including many in Scotland, wanting to understand more about this new medicine.

We hope that Litfulo will be a treatment option for many patients with severe alopecia areata across the whole of the UK. Unfortunately, in reality, we are still unsure what will happen for patients wishing to access this treatment via the NHS. We know that dermatology referral pathways continue to be challenging for many, with many patients with alopecia experiencing difficulties in getting a referral to a dermatologist, along with dermatology waiting times, and we know Litfulo is likely to only be prescribed by a dermatologist. It is well recognised that the quality and availability of healthcare services can vary significantly based on where you live.  We sincerely hope this will not be the case for Litfulo.

We will, of course, also continue our work to provide information to on how to live well with alopecia, so that those who either cannot have treatment, are unsuccessful with treatment, or choose not to have treatment, are empowered with confidence. This work is just as important to us as our work to advocate for fairer treatment pathways.”

Ritlecitinib (Litfulo) is a prescription medicine, from a group of medications called Janus kinase (JAK) inhibitors, that works inside the body to treat severe alopecia areata. Ritlecitinib (Litfulo) binds to select proteins within immune cells and blocks their signalling process to decrease the number of immune cells attacking the hair follicle. 

We know that the news of SMC’s acceptance of ritlecitinib (Litfulo) for NHSScotland may lead to further questions from our community.

We may not have all the answers immediately, but we have pulled together some information below that we hope you will find helpful.

Please also note that Alopecia UK cannot give medical advice and we urge anyone with any questions about treatment to address those to their doctors in the first instance.

* severe alopecia areata includes alopecia totalis and alopecia universalis 

Please read through the information provided, especially our FAQs page, before contacting us with any further questions. 


How is severity of alopecia areata graded? (SALT scoring explained)

What does the clinical trials data show for ritlecitinib (Litfulo)?

JAK inhibitors - treatment options, not a cure

Alopecia UK Community Narrative