Alopecia totalis is a rare but serious form of hair loss where you lose all the hair on your scalp. While alopecia areata usually causes bald patches, alopecia totalis leads to complete scalp baldness. It can come on suddenly or develop gradually. But what exactly is it? What are the possible causes and symptoms? And what treatment or support options are available? In this blog, we’ll explain it all clearly.
What is Alopecia Totalis?
Alopecia totalis involves total loss of hair on the scalp and may also affect the eyebrows and eyelashes. In some cases, it can progress to alopecia universalis, which causes complete hair loss across the entire body.
Although rare, this type of hair loss can have a major impact on daily life. It can occur at any age but usually begins before the age of 40. In most cases, it’s caused by an overactive immune system that mistakenly attacks your hair follicles. As a result, hair growth stops, and the hair falls out.
What triggers this type of hair loss?
The main cause of alopecia totalis is usually an autoimmune response, where your immune system sees hair follicles as threats and attacks them. It’s not entirely clear why this happens, but several factors may play a role:
- Genetic predisposition – If alopecia runs in your family, your risk may be higher
- Stress – Can disrupt your immune balance and potentially trigger hair loss
- Infections or viral illnesses – Sometimes a recent illness sets it off
- Hormonal changes – Such as puberty or menopause
There’s no evidence that diet or shampoos directly cause alopecia totalis. However, maintaining a healthy lifestyle and taking care of your scalp can support your overall wellbeing.
Alopecia Totalis symptoms
Symptoms often begin with one or more bald patches on the scalp, like alopecia areata. Over time, this may progress to complete baldness of the scalp. It’s usually painless, although some people report a tingling sensation.
Common signs include:
- Rapid and nearly complete loss of scalp hair
- Brittle or ridged nails
- Tingling or itching on the scalp
A quick diagnosis can help you take the right steps. If you’re unsure, always consult your general practitioner or a dermatologist.
Is Alopecia Totalis temporary or permanent?
Alopecia totalis develops differently in each person. For some, hair regrows naturally within a few months. For others, the hair loss can be long-term or even permanent. In general, the longer there is no regrowth, the smaller the chance of full recovery.
Often, alopecia totalis develops shortly after the first bald spots from alopecia areata, typically within six months. Children may have a slightly better chance of recovery. However, predicting the course of the condition remains difficult, especially without medical support.
Treating Alopecia Totalis: what are your options?
There is no one-size-fits-all cure for alopecia totalis. Still, several treatments may help, depending on the individual. It’s important to work with a medical professional to find the best option for you.
Some of the most common treatments include:
Corticosteroids: Anti-inflammatory creams or injections that help calm the immune system and limit further hair loss.
Topical immunotherapy (DPCP): A treatment where a chemical is applied to the scalp to provoke a mild allergic reaction. This aims to 'distract' the immune system, so it stops attacking hair follicles. It may sound unusual, but it can be surprisingly effective for some.
UVB phototherapy: A medical light treatment that reduces inflammation and may promote hair growth. Always done under the supervision of a dermatologist.
Products that promote hair growth: Such as the Neofollics Hair Growth Stimulating Lotion. This topical product contains scientifically supported ingredients such as Neoxyl®, Ecklonia cava and green tea extract. It provides a minoxidil-free alternative with fewer side effects. While not a guaranteed cure for alopecia totalis, it can help improve scalp condition and support new hair growth where possible.
If medical treatments don’t bring results, wigs and hair systems are a valuable and empowering alternative. Today’s options are more realistic, comfortable and stylish than ever before, offering a great confidence boost.
The emotional impact of Alopecia Totalis
Alopecia totalis doesn’t just affect your appearance: it can also take a toll on your mental and emotional wellbeing. Losing your hair suddenly can trigger feelings of insecurity, sadness or even shame. Many people say they need to re-learn how to accept themselves.
That journey isn’t easy, but you don’t have to face it alone. It can help to talk to others who understand what you’re going through. Support can be found in online communities, such as:
- Facebook group: “Alopecia Totalis & Universalis Support Group”
Tips for emotional support:
- Talk to others through forums or social media: sharing your story can be a huge relief
- Speak with a therapist or coach if you feel stuck
- Wear whatever makes you feel comfortable: baild, hat, scarf or wig? It's your choice
- Focus on what makes you you! Your hair does not define your worth
Give yourself time. Everyone’s path is different, and there’s no right or wrong way to cope.
FAQ
Is alopecia totalis hereditary?
Sometimes. Genetics play a role in around 20% of cases.
Can stress cause alopecia totalis?
Stress isn’t a direct cause, but it can trigger symptoms if you’re genetically predisposed.
Is it permanent?
For some, hair grows back. For others, it may not. Outcomes vary widely.
Is a hair transplant possible?
Usually not. Because the immune system remains active, transplants are rarely effective.
Conclusion
Alopecia totalis is a rare but impactful condition that affects both your body and your emotions. While there’s no guaranteed solution, there are options to improve your situation or support you through it. What works best depends entirely on you: some opt for treatment, others for wigs, and many choose to embrace it. All choices are valid.
Would you like tailored advice on hair care, suitable products or choosing a wig that fits your style? Our hair specialists are here to listen and help you move forward with confidence.
Sources
National Center for Biotechnology Information (NCBI)
British Association of Dermatologists (BAD)
