What is Alopecia Totalis and How Does it Affect Hair Loss?
Alopecia Totalis (AT) is a chronic condition that can cause an individual to lose all their scalp hair.
The condition is genetic to some extent. According to the Genetic and Rare Diseases Information Center, if you have AT, there is a 20% chance of having a family history of Alopecia.
AT can occur at any age, but it is more likely to affect teenagers and adults below 30.
Even though it is a severe condition. You can still get a positive response if you start treatment early.
Read on to learn more about the condition and how to prevent it.
What is Alopecia Totalis
It is the most severe subtype of Alopecia areata affecting about 0.03% of the world population.
Alopecia Totalis is an intermediate stage that comes between Alopecia Areata and Alopecia Universalis.
Alopecia Totalis can be divided into two types.
One is where all hair follicles are destroyed almost simultaneously. Another is the Chronic persistent type, where the condition worsens gradually from Alopecia Areata.
Symptoms
The primary symptom of Alopecia Totalis is a complete loss of hair on the scalp.
Often AT begins with Alopecia Areata.
You begin to lose small patches of hair, spreading it over time until you lose all of your scalp hair.
Hair fall may start suddenly, and you may lose hair rapidly.
In some cases, your eyebrow and eyelash hair may affect due to this condition.
If you have Alopecia Totalis, it can also affect your nails, making them brittle.
Causes
The definitive cause of Alopecia Totalis is still unknown.
However, researchers believe that genetics and autoimmunity are the main contributing factors.
Sometimes, the body’s immune system identifies hair follicles as a threat by mistake.
In such cases, the body’s defense system attacks healthy hair cells, causing inflammation. It leads to hair loss.
Risk factors
Alopecia Totalis is an autoimmune disease. However, it is unclear why a person develops it.
According to the organization DermNet, children and adults below 30 have higher risks of developing AT.
Sometimes genetics can also be a risk factor as people with a family history of Alopecia may come down with it.
Consult your doctor if you are suffering from extreme stress. Because doctors also link high-stress levels with developing Alopecia.
Treatment
There are few specific studies evaluating the treatment of Alopecia Totalis.
Here are some treatments your doctor may suggest based on your diagnosis and medical condition.
- Topical Immunotherapy
- Phototherapy
- Immunosuppressive Agents
- Topical Minoxidil
- Pulsed Systemic Steroids
Despite the several effective treatments, controlling AT is often challenging. This is mainly due to the unpredictable response from these treatments.
The condition is very unexpected. Because your hair may grow back without treatment and again fall out.
Topical Immunotherapy
There is no FDA-approved medicine for AT.
According to research, Topical Immunotherapy is the best-documented option for AT so far.
Since the 1970s, the treatment has been recommended as the first-line treatment for Immune-mediated diseases.
Topical Immunotherapy boosts our immune system to fight this condition.
If your body responds well to the therapy, your hair may start to grow again.
Immunosuppressive Agents
Immunosuppressive agents subdue the immune system’s attack on the hair cells.
It works by stimulating hair growth.
You can take oral Immunosuppressants combined with other Immunosuppressants for best results.
For a severe case of AT, your doctor may recommend you Methotrexate or Prednisone.
Treatment can sometimes show side effects such as stomach pain, fatigue, and weight gain.
Phototherapy
There are other treatment options available if Topical Immunotherapy remains unresponsive.
Phototherapy with Ultraviolet A-1 (UVA-1) is one such alternative treatment option.
The treatment is effective due to its modulatory effect on the skin’s immune system.
It is more effective if you start the treatment early in the stages of Alopecia Areata.
Furthermore, studies have observed levels of improvement for more than six months.
Pulsed Systemic Steroids
Administration of Pulsed Systemic Steroids, when given early, is an effective and well-tolerated treatment option.
Steroids counteract the attack by the Immune system on healthy hair follicles.
According to the studies, Steroid Pulse Therapy offers a satisfactory response rate for patients with AT.
Alopecia Areata vs Totalis vs Universalis
The three main types of Alopecia are Areata, Totalis, and Universalis.
The three stages of Alopecia start with Areata.
The last most severe stage is Universalis, where you suffer from complete hair loss on the whole body.
Alopecia Areata | Alopecia Totalis | Alopecia Universalis |
Causes hair loss in patches | Causes complete hair loss on the scalp | Causes complete hair loss |
Affects your whole body | Affects primarily the scalp, and sometimes eyebrows and eyelashes | Affects your whole body |
A most common condition affecting 1 in 1000 | A rare condition affecting one 20,000 | An uncommon condition affecting one in 100,000 |
In closing
Alopecia Totalis is a chronic condition that affects one in 20,000 people.
It is a rare and unpredictable condition, but you can control it by starting the treatment early.
The treatment itself can sometimes be long and hectic. Thus it is important that you stay patient during the recovery.
Alopecia Totalis does not harm your health. But it can lower your confidence and affect your emotional health.
You can explore support groups or talk with a counselor to keep yourself motivated.
Though total recovery is challenging, staying positive during the treatment can go a long way.
Frequently Asked Questions
Can you recover from Alopecia Totalis?
According to older studies, Alopecia Totalis is a rare condition with an 8.5% complete recovery rate. But if you start treatment at an early stage, it has more chances of recovery to some extent.
How does Alopecia Totalis start?
Alopecia totalis is an Intermediate stage that starts after Alopecia Areata. It begins with the loss of small patches of hair, and you become completely bald.
How common is Alopecia Totalis?
Alopecia Totalis is a very rare hair loss condition that affects one in 20,000 people. That is, around 0.03% of the world population can suffer from Alopecia Totalis.
Can Alopecia Areata become Alopecia Totalis?
Yes. If you have Alopecia Areata, there is a 5% chance that you will develop Alopecia Totalis.
What triggers Alopecia Totalis?
Alopecia Totalis can trigger due to a faulty Immune system. Additionally, if anyone in your family has Alopecia then you may develop it.
WowRx uses only high-quality sources while writing our articles. Please read our content information policy to know more about how we keep our content reliable and trustworthy.
- medicalnewstoday.com
- pubmed.ncbi.nlm.nih.gov
- pubmed.ncbi.nlm.nih.gov
- hcplive.com
- accessdata.fda.gov
- B. Burroway, J. Griggs, A. Tosti@Alopecia totalis and universalis long-term outcomes: a review
- Mahasaksiri T , Kositkuljorn C@Application of Topical Immunotherapy in the Treatment of Alopecia Areata: A Review and Update