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How To Treat Alopecia Totalis?

alopecia totalis

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    Alopecia totalis is the complete loss of hair from the scalp. In majority of the cases it is identified as an autoimmune disorder. In other words it is an advanced form of alopecia areata and can further progress into alopecia universalis as well. Due to its severity, getting an effective treatment for this condition can be tough. Therefore, it is recommended to look for symptoms or alopecia totalis in order to detect it at an early stage and treat in time.

    What Is Alopecia Totalis?

    It is a total or a near-total loss of hair from the scalp and face. In most of the cases, alopecia totalis leads to non-scarring hair loss. It is an advanced form of alopecia areata. While its exact cause is still not known, it is usually linked to an autoimmune disorder. Our genetics also play a crucial role in alopecia areata totalis.

    It starts with the development of bald patches on the scalp due to alopecia areata. Later, it leads to a complete loss of hair on the scalp. A progressive stage can also cause facial hair loss as well. It has been assumed that around 2% of the total population can suffer from alopecia areata. Out of those, 1-2% cases can lead to this condition.

    Out of all the individuals suffering from alopecia areata, 1-2% can have alopecia totalis. While this condition can target people of any age, it is mostly found in children and adults (of age 40 and under). Alopecia totalis in men is more common than women. Almost 1 in 125 thousand men and 1 in 250 thousand women can suffer from alopecia totalis or universalis.

    Alopecia Totalis Vs. Alopecia Universalis

    In order to learn more about hair regrowth, it is important to differentiate between alopecia totalis and universalis. In alopecia totalis, hair loss is witnessed on the scalp and face (including eyebrows and beard). When alopecia totalis progresses to a more aggressive stage, it leads to alopecia universalis. In alopecia universalis, a complete loss of hair is seen on the entire body. This includes the scalp, face, and all the other body parts.

    Must Read: What Are The Different Types Of Hair Loss (Alopecia)?

    Symptoms Of Alopecia Totalis

    Alopecia totalis can be linked to genetics or can be triggered by any other condition. Furthermore, symptoms of this condition might vary from one individual to another which include –

    • Formation and spreading of bald patches on the scalp.
    • Discomfort on the scalp related to itchiness and dryness.
    • Pitted and brittle nails.
    • Any other autoimmune disorder.

    What Are The Causes Of Alopecia Totalis?

    If you are showing symptoms of this dreadful hair loss condition, then you must be wondering what is the cause of alopecia totalis? Sadly, the exact cause of this condition is still not known. While it is hard to pin a major cause or trigger, alopecia totalis causes are majorly linked to our immune system.

    As you know, our immune system is responsible for fighting illness or any harmful foreign body. In an autoimmune condition, the immune system starts attacking the body itself. It has been assumed that in alopecia totalis, the immune system attacks our hair follicles, leading to inflammation and complete hair loss.

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    Does Hair Grow Back After Treatment?

    Hair might grow back after treatment, when the immune system would stop attacking the hair follicles. Though, it might take its own time. Also, the probability of alopecia totalis getting treated on its own is not very high. Therefore, if you want to attain hair regrowth, then you should look for a dedicated treatment.

    Treatments For Alopecia Totalis

    Since alopecia totalis is an aggressive condition with unknown causes, there is no ideal treatment for it. After examining your scalp, the doctor would suggest different approaches and therapies, that include –

    1. Immunotherapy – Since conditions like alopecia totalis and alopecia universalis are linked to autoimmune disorders, immunotherapy is mostly recommended to stabilize them. There are different approaches to perform an immunotherapy that can be classified as active, passive, or hybrid. Certain substances are introduced into our body in order to regulate our immune system. In the end, our body stops targeting hair follicles and results in new hair growth.
    2. Steroid Treatment – Another popular treatment is related to the use of steroids. In this, corticosteroids are used to inhibit the overall impact of our immune system. This stops the attack on healthy hair follicles and tissues. While it might take a while to regulate the hair growth cycle, the treatment has shown positive results in a lot of cases.
    3. UV Light Therapy – This is an experimental treatment; which scientists are still researching to gain constructive results. In this, UV light rays are used to improve the circulation of blood in the scalp. This strengthens our hair follicles and improves the hair regrowth cycle. The treatment is mostly combined with a dedicated immunotherapy procedure.
    4. Other Treatments – There are several other new-age and experimental treatments that your doctor might recommend as well. Topical treatments related to Diphencyprone (DPCP) and Minoxidil and quite common these days. Potential treatments also include the use of drugs like ruxolitinib and tofacitinib. You can consult an experienced doctor to explore these approaches in detail.

    Must Read: Which Is The Best Treatment For Hair Loss?

    Alopecia Totalis Recovery Rate

    Since there is no ideal treatment for alopecia totalis, it has a low recovery rate. Its progress and recovery largely vary from one individual to another. Mostly, it takes 2 years for the disease to progress with no or low recovery. Nevertheless, sometimes it just stops progressing on its own as well.


    • Are There Any Tests or Diagnosis Available?
      Yes – in order to confirm this condition, a doctor would perform a thorough scalp examination. Besides a visual exam, a scalp biopsy can also be performed. In this, a sample from the scalp’s skin is taken and processed in the lab. Also, your blood can be taken to examine the presence of an autoimmune disorder.
    • Can I Recover Completely From Alopecia Totalis?
      The recovery rate of alopecia totalis is quite low. If an individual has the condition for more than 2 years, then it is pretty unlikely to recover from it. Though, if the doctor is able to stop the immune disorder and work on a hair regrowth technique, then you might see fruitful results in the long run.

    If your body is showing the early signs of alopecia totalis, then visit a doctor and get your scalp checked. Try to detect the problem at an early stage to get better results.

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    About The Author

    Kushneet Kukreja

    Kushneet Kukreja

    A postgraduate in Biotechnology from Kingston University and an ISSA Certified Specialist in Fitness & Nutrition, Kushneet Kukreja is a passionate writer who works in close association with the dermatologists at our head office to generate valuable and scientifically accurate content for our blog.

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