Alopecia Universalis: Unveiling Causes, Effective Treatment and Hair Regrowth Solutions

“Hair loss” does not always mean loss of hair on the top of the head. It can also be loss of hair in other parts of the body. Alopecia Universalis is a condition when people start losing all their hair, not just hair on the head.

Alopecia universalis (AU) is a condition of hair loss and is a subtype of alopecia areata, in which the patient’s immune system attacks hair follicles, thus causing hair loss. Alopecia Universalis is known for complete scalp and body-wide loss of hair. ⁽¹⁾

The word alopecia means “hair loss” and someone with alopecia universalis loses all their hair, including hair on the head, eyebrows and eyelashes, facial hair, and body hair.

Although alopecia areata is pretty common, alopecia universalis is much rarer and affects only 1% of people with alopecia areata overall. ⁽²⁾

Alopecia Universalis begins as alopecia areata. The hair loss can occur suddenly, producing bald spots in just a few days. As the condition progresses to alopecia universalis, hair loss continues to spread until there is no hair left on the body or head.

Currently, there is no specific cure for alopecia universalis. However, there are several treatment options that you might consider discussing with your dermatologists and find out the best approach for your condition.

Alopecia Universalis is an advanced form of alopecia areata. It is an immune system disorder, where the immune system of the body mistakenly attacks the hair follicles. This immune system attack makes the hair fall out.

Some causes of Alopecia Universalis could include:

It is not only the immune system that causes alopecia universalis. According to the National Alopecia Areata Foundation, it has been described that alopecia areata can run in families. ⁽³⁾ However, to pass alopecia areata on to their children, both parents should contribute specific genes.

Because it requires genes from both parents, many individuals with any type of alopecia areata, including alopecia universalis, will usually not pass the condition to their children.

The environment can also play a role in the occurrence of alopecia universalis. The Journal of the American Academy of Dermatology has reported that identical twins only get alopecia areata together half of the time. ⁽⁴⁾

This suggests that environment, along with the immune system and genetics, could trigger hair loss ultimately. However, this environmental trigger remains unknown and could be allergy, illness, hormones, toxins, or anything else.

Alopecia Universalis, particularly has not been proven to be linked with stress. However, it could be possible that extreme stress, along with genetics and problems of the immune system, could trigger alopecia areata and alopecia universalis.

NOTE: There are no medical studies that have proven this association.

Hair loss due to stress, also known as telogen effluvium is a type of hair loss that is temporary and not linked with immune or genetic factors. In such a condition, hair loss occurs several months after any stressful event and usually resolves itself within a few months. However, it should be mentioned that telogen effluvium is in no way related to alopecia universalis.

Alopecia universalis is not a life-threatening condition. However, living with it increases the risk of several other health problems. Some of these complications include:

• Scalp burn from sun exposure is possible because alopecia universalis can cause baldness, which increases the risk of scalp burn. These sunburns also increase the risk of developing skin cancer on the scalp. So, you should protect yourself by applying sunscreen to the bald spots on your head, and also wear a wig or hat while being outside.
• Alopecia universalis also causes you to lose your eyelashes and eyebrows. This makes it easier for debris to enter your eyes. So, wear protective eyewear when outdoors.
• You might also experience loss of nostril hair if you have alopecia universalis, and this in, turn, makes it easier for germs to enter your body and result in various respiratory diseases. So, make sure to protect yourself by limiting contact with diseased people and consult with your doctor about getting proper vaccinations to prevent yourself from respiratory illnesses.

Alopecia universalis causes distinctive signs. Doctors can diagnose the condition by observing the pattern of hair loss. It is extremely smooth and nonscarring, and there is an extensive loss of hair.

A scalp biopsy might be ordered by your doctor to confirm if you have alopecia universalis. This biopsy involves removing a sample of skin from the scalp and observing it under a microscope.

Blood tests might also be performed for an accurate diagnosis. Your doctor would advise specific blood tests to rule out other conditions that could cause hair loss, such as lupus and thyroid disease.

No therapy can cure alopecia universalis. However, the treatment chosen for this condition often depends upon the patient’s age, medical history, and the severity of their hair loss. Some medications that could work include:

It is a topical drug that can treat alopecia areata in some people and thus can also be used for treating the symptoms in people with alopecia universalis.

Squaric acid dibutylester is another medication used to treat alopecia areata. Patients with alopecia universalis can also advised by their doctors to use this drug for their condition.

Steroids are used to calm down the immune response and inflammation. Oral corticosteroids (or steroids), such as Prednisone, are the oral immunosuppressants used for treating alopecia universalis. These are considered to be the first-line treatments early in the course of alopecia universalis and are beneficial because they help stop an overactive immune system in its tracks. ⁽⁵⁾

Sometimes, steroids like methylprednisolone might also be combined with cyclosporine, which is another type of immunosuppressive drug. ⁽⁶⁾ In the case of alopecia universalis, immunosuppressive drugs might help by preventing the immune system from attacking healthy hair follicles.

Bimatoprost is a prescription eye drop treatment, which is approved for treating glaucoma and also helps in eyelash growth. Your dermatologist might prescribe these eye drops to help eyelash regrowth with alopecia universalis. ⁽⁷⁾ 

The outlook for hair regrowth in the case of alopecia universalis varies from person to person. Some individuals lose all of their hair that never grows back, even with all sorts of treatments. While others experience positive results from prescribed treatments and show significant hair regrowth.

One cannot predict how your body will respond to the treatment. You should consult with your doctor if you are experiencing difficulty coping with alopecia universalis or if you require any sort of counseling and support to deal with the condition.

Following are some studies that offer hope for hair regrowth, although none of them have yet been shown to be effective in clinical trials.

Study 1: According to a report published in the Journal of Investigative Dermatology, it has been mentioned that a man experienced a total regrowth of his hair after being treated with tofacitinib citrate, a psoriasis drug. ⁽⁹⁾ It was an accidental discovery as the man was using this drug to treat psoriasis, not alopecia. However, after eight months of treatment, he regained the hair on his head. 

Study 2: The Journal of the American Medical Association had a report that stated that a teenage girl with alopecia universalis achieved success with a topical medication named “Ruxolitinib”. ⁽⁹⁾ Ruxolitinib is commonly used to treat a bone marrow disorder. After the girl applied this medicine for several months to her eyebrow area, she started experiencing significant hair regrowth on her eyebrows.

Some people having alopecia universalis experience severe mental and emotional health issues after losing their hair. Some of them use a wig or other hairpiece to feel better about their appearance, while others might not choose using wigs. No matter what, at a point in time, people with alopecia universalis might start feeling low and lose hope.

However, one should remain informed that support groups are available and these groups help people cope with hair loss and emotional or mental health issues they might be facing due to the same.

According to The National Alopecia Areata Foundation, it has been stated that around 150 million people globally have some form of alopecia areata ⁽¹⁰⁾, while 1 in 4, 000 individuals in the world has alopecia universalis. ⁽¹¹⁾ Individuals with alopecia universalis can find online as well as in-person support groups that would help them cope with the condition as they can share their experiences with each other and boost their confidence. So, if you have been encounter with alopecia universalis, do not lose hope, just take support from various support groups and do not delay in seeing an expert and getting yourself treated by an expert.

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