The article describes the first case of a pediatric patient with alopecia universalis who failed baricitinib treatment. After switching to ritlecitinib, there were favorable clinical results. Alopecia areata is a disease with complex treatment and frequent recurrences, which causes significant physical and psychological problems for children. Current treatment options for the childhood form are limited, with low efficacy and many side effects. The authors report this case as significant for understanding the treatment of chronic severe alopecia areata in children.