Table of ContentsView AllTable of ContentsSymptomsRisksHow to Get Hair Loss DiagnosedHair RegrowthTreatmentsCopingResearch Advancements
Table of ContentsView All
View All
Table of Contents
Symptoms
Risks
How to Get Hair Loss Diagnosed
Hair Regrowth
Treatments
Coping
Research Advancements
Alopecia universalisis a common skin disease that causes sudden total hair loss on your scalp, face, and body. It occurs when a faulty immune system attacks healthy hair follicles.
Alopecia universalis is a severe form ofalopecia areata, which causes patchy hair loss on your scalp and face. Another form of this disease, calledalopecia totalis, causes total hair loss on your scalp.
There is no cure for this disease. While it can be hard to regrow lost hair, treatments can sometimes improve symptoms. Some of the most hopeful treatments involve newer drugs called Janus kinase (JAK) inhibitors.
Symptoms: What’s Different About Alopecia Universalis?
Symptoms of alopecia universalis typically begin withalopecia areata, which involves patchy areas of baldness on your scalp or other areas of your body that grow hair. The conversion to alopecia universalis can expand to include total hair loss, often in a very short period, on your scalp and all hair-producing areas of your body, including:
Any form of alopecia areata can include the following symptoms:
While hair loss is characteristic of alopecia universalis, it can also occur as a symptom of a medical condition likelupus, medication side effects, a nutritional deficiency, or other health conditions, so it’s important to get an accurate diagnosis for the cause of your hair loss to ensure appropriate treatment.
6 Types of Alopecia and How They’re Treated
What Causes It?
The exact cause of alopecia universalis is unknown. However, research indicates that it is likely anautoimmune disease. This type of condition occurs when an overactive immune system mistakes healthy cells for foreign substances and attacks them. In alopecia universalis, your immune system attacks and destroys healthyhair follicle structures, which results in hair loss.
People who have alopecia universalis have a change in theirgeneticmaterial. However, alopecia universalis is considered a polygenic disease, meaning it is related to multiple genetic factors. As a result, not everyone with the same genes will get the disease.
Research on identical twins has shown that identical twins only get alopecia areata together about 55% of the time. This suggests that forms of alopecia areata are not simply related to genetics. Instead, they may occur due to a combination of inherited and environmental factors.
Factors that may contribute to the development of alopecia universalis include:
You have a higher risk of getting alopecia univeralis if you have a family member who has the disease. Your risk is higher if that relative lost their hair before age 30.
If you have bald patches or an increase in hair loss, contact your healthcare provider or a dermatologist, a specialist in disease and conditions of the skin. With so many potential causes for hair loss, only a healthcare provider can confirm the source of your symptoms.
A diagnosis of alopecia universalis may be made based on the following evaluations:
There are also tests to check for active hair loss. These include:
Based on your symptoms, one or more of the following tests may also be used to confirm your diagnosis:
Alopecia Universalis and Hair Regrowth: What’s Possible?
While hair regrowth can happen after many years of severe or widespread hair loss, it is not common. The chance of full hair regrowth and recovery in alopecia universalis is below 10%.
Treatment Options
Janus Kinase Inhibitors
JAK inhibitorsare immunomodulatory drugs, which modify your immune system. They interfere with JAKs, which stimulate your immune cells and produce blood enzymes calledcytokines.
Overproduction of proinflammatory cytokines can trigger inflammation. By curbing the production of JAKs, JAK inhibitors decrease the number of cytokines. With fewer cytokines, inflammation is reduced, creating a more favorable environment for hair regrowth.
While JAK inhibitors offer promising results for treating alopecia universalis, the FDA requires that these drugs carry a boxed warning about the possibility of the following side effects:
JAK inhibitors are sometimes used with one of the following therapies to treat alopecia universalis and other types of severe alopecia.
Oral Minoxidil
Oral minoxidilis a tablet form ofthe main ingredient in Rogaine, a topical treatment formale-pattern baldnessandfemale-pattern hair loss.
Research indicates that low doses of oral minoxidil, commonly used to treat high blood pressure (hypertension), can further promote hair regrowth in some cases of alopecia areata when used in conjunction with an immune modulator or immunosuppressive agent. Oral minoxidil is sometimes used off-label as an alternative to topical minoxidil.
Oral minoxidil has a low incidence of adverse effects. The most common side effects include:
Intralesional Corticosteroids
Hair regrowth can occur within six to eight weeks when successful, with the process repeated every four to six weeks when hair regrows. If there is no hair regrowth after six months, treatment should be discontinued.
Side effects can be injection site-related or treatment-related.
Injection site side effects may include;
Treatment-related side effects can include:
Contact Immunotherapy
Contactimmunotherapyattempts to get your immune system to stop attacking your hair follicles, which causes hair loss. The treatment induces an inflammatory response to the applied area. The success of this treatment for hair regrowth ranges from 17% to 75%.
Contact immunotherapy has a relatively low rate of side effects. When complications occur, they can include:
Other Oral Medications
Treatment regimens for alopecia universalis can vary significantly. Your dermatologist may also prescribe one of the following oral medications, among others:
Clinical Trials
If you have alopecia universalis that has not improved with traditional treatments, you may benefit from enrolling in a clinical trial. Clinical trial volunteers gain access to a potential new medication before it is available to the public.
Talk to your healthcare provider regarding the benefits and potential drawbacks of volunteering in a clinical trial and whether it may be right for you.
How Diet and Supplements Work in Treating Alopecia UniversalisResearch indicates that insufficiencies of certain micronutrients, includingvitamin D,zinc, andvitamin A, are linked to the incidence and severity of all forms of alopecia areata. These nutrients play key roles in immune function and may be valuable as adjunct treatment options for all types of alopecia areata.A diet that excludes autoimmune trigger foods and replenishes these key micronutrients through food and supplements may be valuable in treating alopecia universalis.
How Diet and Supplements Work in Treating Alopecia Universalis
Research indicates that insufficiencies of certain micronutrients, includingvitamin D,zinc, andvitamin A, are linked to the incidence and severity of all forms of alopecia areata. These nutrients play key roles in immune function and may be valuable as adjunct treatment options for all types of alopecia areata.A diet that excludes autoimmune trigger foods and replenishes these key micronutrients through food and supplements may be valuable in treating alopecia universalis.
Research indicates that insufficiencies of certain micronutrients, includingvitamin D,zinc, andvitamin A, are linked to the incidence and severity of all forms of alopecia areata. These nutrients play key roles in immune function and may be valuable as adjunct treatment options for all types of alopecia areata.
A diet that excludes autoimmune trigger foods and replenishes these key micronutrients through food and supplements may be valuable in treating alopecia universalis.
Coping With Hair Changes
While the emotional aspects of the disease can be discouraging, taking the following steps can help you remain positive, deal with your symptoms, and cope with the challenges of alopecia universalis:
You can find support groups via the following organizations:
Research advancements in the treatment of alopecia universalis include:
Summary
Alopecia universalis occurs as a more extreme type of alopecia areata. Research suggests this disease is linked to a faulty immune system attacking healthy hair follicles.
Though hair regrowth can occur independently in people with alopecia universalis, full hair regrowth is likely in about 10% of cases. The success of new treatments like JAK inhibitors provides more options for people living with this disease.
While alopecia universalis does not pose a threat to your health, the emotional toll of the disease can be severe. Joining a support group and/or working with a counselor can help you cope with the challenging aspects of this condition.
Contact your healthcare provider or a dermatologist if you notice rapid hair loss in any area of your body. Hair loss can signify other diseases that can become severe without treatment. Getting the right diagnosis can help you address symptoms early for the best results.
22 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Genetic and Rare Diseases Information Center (GARD).Alopecia universalis.National Alopecia Areata Foundation.What is alopecia areata?National Alopecia Areata Foundation.Available treatments.National Alopecia Areata Foundation.Symptoms and diagnosis.Harvard Health Publishing Harvard Medical School.Hair loss.National Alopecia Areata Foundation.What is alopecia areata?Mitra D, Agarwal R, Chopra A, Kandpal R.Rare presentation of alopecia universalis congenita and twenty-nail dystrophy in siblings.Int J Trichology. 2017 Apr-Jun;9(2):63-66. doi:10.4103/ijt.ijt_48_17Sy N, Mastacouris N, Strunk A, Garg A.Overall and racial and ethnic subgroup prevalences of alopecia areata, alopecia totalis, and alopecia universalis.JAMA Dermatol. 2023 Apr 1;159(4):419-423. doi:10.1001/jamadermatol.2023.0016National Alopecia Areata Foundation.Alopecia areata types.Akritidou F, Misiou K, Tsanidou E, Katsaras GN, Papamitsou T.Unexpected hair regrowth in a woman with longstanding Alopecia universalis.GMS Ophthalmol Cases. 2021 May 11;11:Doc08. doi:10.3205/oc000181.Katella K. Yale Medicine.New alopecia areata treatment aims to help adults and adolescents.Food and Drug Administration (FDA).FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.Cleveland Clinic.Oral minoxidil offers strong results against alopecia.British Association of Dermatologists.Intralesional steroid therapy.American Academy of Dermatology Association (AAD).Hair loss types: alopecia areata diagnosis and treatment.Mahasaksiri T, Kositkuljorn C, Anuntrangsee T, Suchonwanit P.Application of topical immunotherapy in the treatment of alopecia areata: a review and update.Drug Des Devel Ther. 2021;15:1285-1298. doi:10.2147/DDDT.S297858National Alopecia Areata Foundation.Alopecia areata research depends on clinical trial volunteers.Harvey CJ.Combined diet and supplementation therapy resolves alopecia areata in a paediatric patient: a case study.Cureus. 2020;Nov 7;12(11):e11371. doi:10.7759/cureus.11371Mount Sinai.Living with alopecia areata: five coping strategies to help with the emotional toll.Craiglow BG, Tavares D, King BA.Topical ruxolitinib for the treatment of alopecia universalis.JAMA Dermatol.2016;152(4):490–491. doi:10.1001/jamadermatol.2015.4445Craiglow BG, King BA.Killing two birds with one stone: oral tofacitinib reverses alopecia universalis in a patient with plaque psoriasis.J Invest Dermatol. 2014;134(12):2988-2990. doi:10.1038/jid.2014.260Joly P, Lafon A, Houivet E, et al.Efficacy of methotrexate alone vs. methotrexate plus low-dose prednisone in patients with alopecia areata totalis or universalis: a 2-step double-blind randomized clinical trial.JAMA Dermatol.2023;159(4):403–4102023. doi:10.1001/jamadermatol.2022.6687.
22 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Genetic and Rare Diseases Information Center (GARD).Alopecia universalis.National Alopecia Areata Foundation.What is alopecia areata?National Alopecia Areata Foundation.Available treatments.National Alopecia Areata Foundation.Symptoms and diagnosis.Harvard Health Publishing Harvard Medical School.Hair loss.National Alopecia Areata Foundation.What is alopecia areata?Mitra D, Agarwal R, Chopra A, Kandpal R.Rare presentation of alopecia universalis congenita and twenty-nail dystrophy in siblings.Int J Trichology. 2017 Apr-Jun;9(2):63-66. doi:10.4103/ijt.ijt_48_17Sy N, Mastacouris N, Strunk A, Garg A.Overall and racial and ethnic subgroup prevalences of alopecia areata, alopecia totalis, and alopecia universalis.JAMA Dermatol. 2023 Apr 1;159(4):419-423. doi:10.1001/jamadermatol.2023.0016National Alopecia Areata Foundation.Alopecia areata types.Akritidou F, Misiou K, Tsanidou E, Katsaras GN, Papamitsou T.Unexpected hair regrowth in a woman with longstanding Alopecia universalis.GMS Ophthalmol Cases. 2021 May 11;11:Doc08. doi:10.3205/oc000181.Katella K. Yale Medicine.New alopecia areata treatment aims to help adults and adolescents.Food and Drug Administration (FDA).FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.Cleveland Clinic.Oral minoxidil offers strong results against alopecia.British Association of Dermatologists.Intralesional steroid therapy.American Academy of Dermatology Association (AAD).Hair loss types: alopecia areata diagnosis and treatment.Mahasaksiri T, Kositkuljorn C, Anuntrangsee T, Suchonwanit P.Application of topical immunotherapy in the treatment of alopecia areata: a review and update.Drug Des Devel Ther. 2021;15:1285-1298. doi:10.2147/DDDT.S297858National Alopecia Areata Foundation.Alopecia areata research depends on clinical trial volunteers.Harvey CJ.Combined diet and supplementation therapy resolves alopecia areata in a paediatric patient: a case study.Cureus. 2020;Nov 7;12(11):e11371. doi:10.7759/cureus.11371Mount Sinai.Living with alopecia areata: five coping strategies to help with the emotional toll.Craiglow BG, Tavares D, King BA.Topical ruxolitinib for the treatment of alopecia universalis.JAMA Dermatol.2016;152(4):490–491. doi:10.1001/jamadermatol.2015.4445Craiglow BG, King BA.Killing two birds with one stone: oral tofacitinib reverses alopecia universalis in a patient with plaque psoriasis.J Invest Dermatol. 2014;134(12):2988-2990. doi:10.1038/jid.2014.260Joly P, Lafon A, Houivet E, et al.Efficacy of methotrexate alone vs. methotrexate plus low-dose prednisone in patients with alopecia areata totalis or universalis: a 2-step double-blind randomized clinical trial.JAMA Dermatol.2023;159(4):403–4102023. doi:10.1001/jamadermatol.2022.6687.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Genetic and Rare Diseases Information Center (GARD).Alopecia universalis.National Alopecia Areata Foundation.What is alopecia areata?National Alopecia Areata Foundation.Available treatments.National Alopecia Areata Foundation.Symptoms and diagnosis.Harvard Health Publishing Harvard Medical School.Hair loss.National Alopecia Areata Foundation.What is alopecia areata?Mitra D, Agarwal R, Chopra A, Kandpal R.Rare presentation of alopecia universalis congenita and twenty-nail dystrophy in siblings.Int J Trichology. 2017 Apr-Jun;9(2):63-66. doi:10.4103/ijt.ijt_48_17Sy N, Mastacouris N, Strunk A, Garg A.Overall and racial and ethnic subgroup prevalences of alopecia areata, alopecia totalis, and alopecia universalis.JAMA Dermatol. 2023 Apr 1;159(4):419-423. doi:10.1001/jamadermatol.2023.0016National Alopecia Areata Foundation.Alopecia areata types.Akritidou F, Misiou K, Tsanidou E, Katsaras GN, Papamitsou T.Unexpected hair regrowth in a woman with longstanding Alopecia universalis.GMS Ophthalmol Cases. 2021 May 11;11:Doc08. doi:10.3205/oc000181.Katella K. Yale Medicine.New alopecia areata treatment aims to help adults and adolescents.Food and Drug Administration (FDA).FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.Cleveland Clinic.Oral minoxidil offers strong results against alopecia.British Association of Dermatologists.Intralesional steroid therapy.American Academy of Dermatology Association (AAD).Hair loss types: alopecia areata diagnosis and treatment.Mahasaksiri T, Kositkuljorn C, Anuntrangsee T, Suchonwanit P.Application of topical immunotherapy in the treatment of alopecia areata: a review and update.Drug Des Devel Ther. 2021;15:1285-1298. doi:10.2147/DDDT.S297858National Alopecia Areata Foundation.Alopecia areata research depends on clinical trial volunteers.Harvey CJ.Combined diet and supplementation therapy resolves alopecia areata in a paediatric patient: a case study.Cureus. 2020;Nov 7;12(11):e11371. doi:10.7759/cureus.11371Mount Sinai.Living with alopecia areata: five coping strategies to help with the emotional toll.Craiglow BG, Tavares D, King BA.Topical ruxolitinib for the treatment of alopecia universalis.JAMA Dermatol.2016;152(4):490–491. doi:10.1001/jamadermatol.2015.4445Craiglow BG, King BA.Killing two birds with one stone: oral tofacitinib reverses alopecia universalis in a patient with plaque psoriasis.J Invest Dermatol. 2014;134(12):2988-2990. doi:10.1038/jid.2014.260Joly P, Lafon A, Houivet E, et al.Efficacy of methotrexate alone vs. methotrexate plus low-dose prednisone in patients with alopecia areata totalis or universalis: a 2-step double-blind randomized clinical trial.JAMA Dermatol.2023;159(4):403–4102023. doi:10.1001/jamadermatol.2022.6687.
Genetic and Rare Diseases Information Center (GARD).Alopecia universalis.
National Alopecia Areata Foundation.What is alopecia areata?
National Alopecia Areata Foundation.Available treatments.
National Alopecia Areata Foundation.Symptoms and diagnosis.
Harvard Health Publishing Harvard Medical School.Hair loss.
Mitra D, Agarwal R, Chopra A, Kandpal R.Rare presentation of alopecia universalis congenita and twenty-nail dystrophy in siblings.Int J Trichology. 2017 Apr-Jun;9(2):63-66. doi:10.4103/ijt.ijt_48_17
Sy N, Mastacouris N, Strunk A, Garg A.Overall and racial and ethnic subgroup prevalences of alopecia areata, alopecia totalis, and alopecia universalis.JAMA Dermatol. 2023 Apr 1;159(4):419-423. doi:10.1001/jamadermatol.2023.0016
National Alopecia Areata Foundation.Alopecia areata types.
Akritidou F, Misiou K, Tsanidou E, Katsaras GN, Papamitsou T.Unexpected hair regrowth in a woman with longstanding Alopecia universalis.GMS Ophthalmol Cases. 2021 May 11;11:Doc08. doi:10.3205/oc000181.
Katella K. Yale Medicine.New alopecia areata treatment aims to help adults and adolescents.
Food and Drug Administration (FDA).FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.
Cleveland Clinic.Oral minoxidil offers strong results against alopecia.
British Association of Dermatologists.Intralesional steroid therapy.
American Academy of Dermatology Association (AAD).Hair loss types: alopecia areata diagnosis and treatment.
Mahasaksiri T, Kositkuljorn C, Anuntrangsee T, Suchonwanit P.Application of topical immunotherapy in the treatment of alopecia areata: a review and update.Drug Des Devel Ther. 2021;15:1285-1298. doi:10.2147/DDDT.S297858
National Alopecia Areata Foundation.Alopecia areata research depends on clinical trial volunteers.
Harvey CJ.Combined diet and supplementation therapy resolves alopecia areata in a paediatric patient: a case study.Cureus. 2020;Nov 7;12(11):e11371. doi:10.7759/cureus.11371
Mount Sinai.Living with alopecia areata: five coping strategies to help with the emotional toll.
Craiglow BG, Tavares D, King BA.Topical ruxolitinib for the treatment of alopecia universalis.JAMA Dermatol.2016;152(4):490–491. doi:10.1001/jamadermatol.2015.4445
Craiglow BG, King BA.Killing two birds with one stone: oral tofacitinib reverses alopecia universalis in a patient with plaque psoriasis.J Invest Dermatol. 2014;134(12):2988-2990. doi:10.1038/jid.2014.260
Joly P, Lafon A, Houivet E, et al.Efficacy of methotrexate alone vs. methotrexate plus low-dose prednisone in patients with alopecia areata totalis or universalis: a 2-step double-blind randomized clinical trial.JAMA Dermatol.2023;159(4):403–4102023. doi:10.1001/jamadermatol.2022.6687.
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