What Is Alopecia Totalis?

This page explains why alopecia totalis and alopecia universalis are by far the worst forms of alopecia areata.

These are the reasons why:

• You could lose all scalp hair in less than a week.
• It can happen at any time.
• It can be permanent.
• Many different things can trigger it.
• It can run in your family.
• No one really knows exactly what causes it.
• It can affect children as well as adults.

However, less than 2% of the general population suffer alopecia areata. And, of these, just 20% will ultimately go on to develop alopecia universalis.

Alopecia totalis When alopecia areata is bad, it's really bad! Alopecia totalis involves complete hair loss of the entire scalp - i.e., not just within the male pattern baldness region (as in most hair loss cases). Even the eyebrows and eyelashes may be lost.

The very strange appearance that results can be extremely distressing. With alopecia totalis, the rest of the body remains unaffected. Sometimes it is also called areata totalis.

Alopecia universalis

Universalis means exactly what it says: universal-loss i.e., everywhere! From nose to toes, complete hair loss occurs throughout the body. This includes the head (as with alopecia totalis) but also the arms, legs, chest, pubic hair, etc.

For both alopecia totalis and universalis, the experience of losing all body hair can be traumatic for all those involved.

Such extensive loss can produce other problems too - losing hair in the nose and ears can make you more vulnerable to the germs, dust, bugs, etc which can then enter the body more easily.

Alopecia universalis is the most severe form of alopecia areata, and perhaps the worst type of any hair loss.

However, people with areata universalis or areata totalis are otherwise generally healthy (although there may be an increased tendency for thyroid disease and/or vitiligo - patchy loss of skin colour).

Of those who develop some form of areata, approximately 40% of males and 30% of females will do so before the age of 15.

Alopecia totalis and universalis in children

If a child develops this type of hair loss before puberty, the likelihood of significant regrowth is not good.

Up to 50% become totally bald and never recover their hair.

And this is especially true if a child is atopic (i.e., suffering eczema or asthma through genetic inheritance). Should such a child lose their hair totally before puberty, it is unlikely to regrow permanently.

However, if older children (i.e., after puberty) experience hair loss, only 25% will become totally bald, and over 5% may recover completely.

Overall though, approximately 20% of all children who experience total scalp hair loss will show no significant regrowth, and only 1% will achieve permanent regrowth.

What causes alopecia totalis and alopecia universalis?

It is thought that there's a genetic link to this disease - it may well be caused by a mutation in a gene.

However, whilst it appears likely that this gene is only carried by those who have alopecia universalis, there may also be other contributing factors that remain unknown.

All forms of alopecia areata are also widely believed to be a type of autoimmune skin disease.

The body's white blood cells treat the hair follicles as foreign bodies and attack the rapidly growing cells in the hair follicles that make our hair. The affected hair follicles then become smaller, and dramatically slow down hair production. Hair growth can then stop altogether.

Unfortunately, the mechanism that actually causes the autoimmune response still remains unknown.

However, the stem cells (which supply the follicle with new cells) are not targeted. This means that, even with complete hair loss, the possibility for full regrowth remains. And this includes even those who have had 100% hair loss for many years.

Here are some words of encouragement:

An experiment with hairless mice, which had scalp grafts from people with alopecia areata, demonstrated that the ability of follicles to grow hair remains normal in this type of hair loss. That's because these mice began to grow hair in the scalp-grafted region.

It also shows that the factors that cause this type of hair loss are circulating within the bloodstream.

So, all hope is not lost despite the absence of a definitive cause.

Treatment of alopecia areata, totalis
and universalis

As a result of the many avenues of research into alopecia areata, several forms of treatment have been developed.

Immunosuppressive drugs - Since alopecia areata is an autoimmune disease, there is an ongoing field of research for possible treatment in this area. These drugs suppress the immune system and may be administered orally, topically or by injection.

Steroids - when administered by injection alone (i.e., not as part of combination treatment) or topically, these methods can only be applied in less severe cases i.e., where under 60% of scalp hair has been lost).

PUVA - Long-wave ultraviolet light can reduce or even eliminate Langerhans cells (which have been linked to alopecia areata) and restore hair growth.

Minoxidil - This lotion is mostly used for male pattern baldness, but has also been applied to some cases of alopecia areata where the hair loss experienced is small and patchy.

Surgery - This might be used in some less severe cases of alopecia areata, but given its unpredictable and recurrent nature, other types of treatment might prove better options.

Primula obconica - This plant has been known to cause an allergic reaction (i.e., skin rashes). Some success has been achieved by using the leaves of this plant in certain cases of this disease.

Nutrition, herbal remedies, etc - Other, perhaps, more unconventional forms of treatment have also been developed, and these may be tried with some success for those suffering all forms of alopecia areata.

Learn more?
Click here for Alopecia Areata, Totalis And Universalis Treatment.

Note that, to accurately diagnose any form of alopecia, you should first consult with a physician.

Leave Alopecia Totalis and go to Alopecia Areata.