Baoli He, Yujia Weng, Peihua Luo, Zhifei Xu, Hao Yan, Bo Yang, Qiaojun He, Jiabin Lu, Xiaochun Yang
Alopecia areata (AA) is an autoimmune disorder characterized by sudden hair loss, affecting millions worldwide. Conventional synthetic drug treatments are often limited by side effects, driving interest in natural alternatives. This review highlights terpenoids, flavonoids, and polyphenols as promising natural compounds that effectively promote hair regrowth in AA. These phytochemicals exert therapeutic effects primarily by activating pro-anagenic signaling pathways, notably the Wnt/β-catenin and phosphoinositide 3-kinase-protein kinase B (PI3K-Akt) pathways, while inhibiting catagen-associated pathways such as transforming growth factor-β (TGF-β), and modulating immune dysregulation through the suppression of Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling. This review has detailed the mechanisms through which these compounds support hair follicle regeneration, restore immune balance, and reduce inflammation. Collectively, the evidence highlights the significant therapeutic potential of natural products for AA, underscoring the need for further translational research.