What is total alopecia?

Some people with alopecia totalis may use makeup to create eyebrows.

Alopecia totalis is a type of alopecia that causes total hair loss, including all facial hair, eyebrows, and eyelashes. This total baldness usually occurs six months after the onset of the disease. The underlying cause of alopecia totalis and other types of alopecia is believed to be an autoimmune disorder. Many people with this condition find that their hair loss is exacerbated by stress, but alopecia is not limited to people with stressful lifestyles.

Topical medications can be helpful in treating alopecia totalis.

Alopecia totalis is a more severe version of alopecia areata, in which hair is lost in patches on the scalp and other areas of the body. A third type of alopecia, called alopecia universalis, leads to the loss of all hair on the body, including the scalp, face, trunk, limbs, and genital area. All of these types of alopecia are recurring conditions that do not cause any harm to a person’s physical health, but can cause considerable psychological and emotional stress.

Alopecia does not harm a person’s physical health, but it can cause considerable psychological and emotional stress.

A considerable amount of evidence points to an autoimmune disorder as the cause of alopecia. Sensitized immune cells and antibodies have been found to destroy hair follicles in people with alopecia, indicating that their immune systems were somehow primed to attack these cells. In one study, 90% of people with alopecia were found to have antibodies capable of attacking certain structures in the hair follicles.

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Scientific evidence also suggests that genetics plays a role in the development of alopecia totalis. One study found that up to 20% of people with alopecia have a family history of the condition, while less than 2% of people without alopecia have a family history of the condition. This and other evidence indicates that certain genes may increase the likelihood that someone will develop alopecia. In the world population, an individual has approximately a 1.7% chance of developing some type of alopecia; the most common type is alopecia areata.

Treatment of alopecia totalis involves the use of topical medications or injections. For people with less than 50% hair loss on the scalp, corticosteroid injections or topical creams are most commonly used. Approximately 60 percent of people who receive regular corticosteroid injections into the scalp will have hair growth within four to six weeks after the first injection.

When more than 50% of the hair on the scalp is lost, treatment is more likely to be topical immunotherapy medications. Chemicals such as squaric acid dibutyl ester are used to induce a mild form of contact dermatitis at the site of hair loss. As a result, the autoimmune response that causes hair loss is inhibited, allowing hair to grow back. Hair growth usually begins 12-24 weeks after the first treatment.

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