Alopecia Universalis- What You Need To Know

Alopecia Universalis is a rare autoimmune disorder that causes total body and scalp hair loss. It can be very distressing to live with and can affect people of any age. In this article, we’ll go through what you need to know about Alopecia Universalis from the symptoms and diagnosis to treatment options and tips on managing this condition daily.

What is Alopecia Universalis?

Alopecia Universalis is a rare autoimmune alopecia, causing total hairloss affecting both the scalp and body. It occurs when your immune system mistakenly attacks healthy hair follicles and prevents them from growing new hair. It can cause sudden and complete loss of all scalp and body hair over the entire surface area, including eyelashes, eyebrows, facial hair and pubic/underarm hair (1). Alopecia Universalis may occur at any age but is much more common in adults aged 20 to 40. While it has no known cure, various treatments exist to help regrow some stray hairs if administered early enough while the condition is still in its active phase.

Alopecia Universalis signs and symptoms

Common symptoms include:

• Loss of hair on the body
• Shortening of hair and loss of hair in the eyebrow and eyelashes
• Loss of hair on the scalp

One of the primary symptoms of Alopecia Universalis is total hair loss from all areas of the body, including facial hair. This type of alopecia can be identified by examining the scalp and skin for signs that suggest complete baldness. Some itching or irritation in the affected area may also accompany the condition.

Other symptoms of of the condition may include a shortening or loss of eyelashes and eyebrows. In addition, the sufferer may notice thinning hair in other areas such as their chest, pubic area, beard or legs. The affected person may also experience flaky skin or scales on the scalp.

It is important to note that Alopecia Universalis is not restricted to the head and face. You can also experience hair loss in other areas of the body, such as the arms and legs. While some people may experience temporary hair regrowth, this usually does not last long and eventually leads to complete baldness(2).

Alongside facial and body hair loss, suffererrs of Alopecia Universalis also lose hair on their scalp. The condition can therefore be identified by examining the scalp and skin for signs of complete baldness.

If you are demonstrating any of these symptoms or signs it is important to consult a medical professional as soon as possible. Early diagnosis and treatment can be key to managing this condition and preventing further hair loss.

Causes of Alopecia Universalis

Alopecia Universalis can be precipitated by a number of events with patients often having an underlying genetic predisposition to the condition.

• Genetic Predisposition: Studies have shown that those who develop Alopecia Universalis are more likely to have a family history of the disorder, indicating that genetics plays a role in developing this condition.

• Physical or Emotional Trauma: Physical trauma or emotional stress can trigger the onset of Alopecia Universalis in some individuals. Severe physical injuries, such as burns or other serious wounds, can also trigger the immune system and result in Alopecia Universalis. Similarly, extreme emotional stress like a family member death can cause an autoimmune reaction leading to hair loss.

• Medical Conditions: Certain medical conditions may be linked to the condition. These include certain types of cancer, lupus, and thyroid diseases.

Diagnosis of Alopecia Universalis

To diagnose alopecia Universalis, a variety of tests can be used. These range from physical examinations to laboratory tests that look for signs of inflammation or infection in the scalp and hair follicles ruling out other rare conditions that can cause hair loss. The following are commonly used tests:

• Physical examination – This involves examining the patient’s scalp and skin, assessing hair loss patterns, and ruling out other possible causes.

• Trichoscopy – This test uses a special device to look for signs of inflammation or infection in the scalp and hair follicles for a more accurate diagnosis.

• Blood tests – These tests measure levels of certain hormones, such as testosterone and thyroid-stimulating hormone (TSH). Abnormal levels can indicate another possible cause of hair loss

• Skin biopsy – Sometimes, a skin sample is taken from the scalp for microscopic examination. This can help rule out other causes of hair loss, such as fungal infections or another type of autoimmune related hair loss condition

Using these tests together makes it possible to accurately diagnose Alopecia Universalis and provide the most effective treatment for each patient. Early diagnosis and treatment can help reduce the impact of Alopecia Universalis on quality of life.

Management of Alopecia Universalis

Treatment for alopecia Universalis may include:

• Topical Steroids: topical steroids are the most common treatment for Alopecia Universalis. They can be applied directly to the scalp and are usually prescribed in a strength correlating to the severity of the condition. They are usually applied twice daily and may take several months to show results.

• Oral Steroids: Oral steroids are generally prescribed for more severe cases and they can be more effective than topical treatments. These medications reduce inflammation in the scalp, which helps promote hair growth but risk wider side effects on the body.

• Immunotherapy: Immunotherapy involves exposing the scalp to a mild irritant, such as diiphencyprone (DPCP), which causes inflammation and encourages the body to produce antibodies against the irritant. As a result, this can help to stimulate hair regrowth in some cases.

These are some of the treatment options available for Alopecia Universalis. However, it is important to note that these treatments can fail to provide any benefit. It is best to discuss all options with a doctor or healthcare provider to determine the best course of action for the patient. In many cases, a combination of medications and treatments may be necessary to achieve optimal results (1).

Can you perform a hair transplant for Alopecia Universalis?

Unfortunately a hair transplant will not work for patients suffering from Alopecia Universalis. The body’s immune system is likely to affect transplanted hair follicles meaning they won’t grow wherever they are transplanted.

Complications of Alopecia Universalis

Alopecia Universalis is a rare autoimmune disorder resulting in hair loss from the scalp and body. While this condition does not typically cause physical symptoms, there are numerous complications associated with alopecia Universalis that can impact both physical and mental health.

The first complication to consider is the emotional impact. People with condition may experience distress, low self-esteem, and anxiety due to the physical changes associated with their condition. They may also be subject to bullying or harassment from others unfamiliar with the disorder.

A second complication is a physical discomfort resulting from the lack of hair on the scalp. Without hair to protect it, the skin may become irritated or sunburned more easily than normal, even with sunscreen or hats. Additionally, people with the condition may experience a higher susceptibility to heat exhaustion and dehydration due to the lack of protection against UV rays (1).

The complications associated with Alopecia Universalis can significantly impact both physical and mental health. It is important for individuals living with the condition to address any emotional distress they may be experiencing and to seek medical attention as soon as possible if they develop signs of infection or another skin condition. Additionally, they should protect their scalp from sun damage and find clothing and headgear that is comfortable to wear over the affected areas. With enough care and support, individuals can manage their condition and live happy, healthy lives.

Conclusion

Alopecia Universalis is a disease that causes hair loss on the scalp and often on other body parts. It can affect both men and women but is more common in women. There is no cure for the condition, but treatments can help slow down hair loss or promote new growth.

References

1: Burroway, B., Griggs, J., & Tosti, A. (2020). Alopecia totalis and universalis long‐term outcomes: a review. Journal of the European Academy of Dermatology and Venereology, 34(4), 709–715. https://doi.org/10.1111/jdv.15994

2: Kassira, S., Korta, D. Z., Chapman, L. W., & Dann, F. (2017). Review of treatment for alopecia totalis and alopecia universalis. International Journal of Dermatology, 56(8), 801–810. https://doi.org/10.1111/ijd.13612