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Alopecia Universalis :Treatment, Procedure, Cost And Side Effects

Last Updated: Mar 15, 2024

What is Alopecia Universalis ?

Alopecia Universalis is a condition characterized by complete loss of hair on the scalp and body. This is a serious problem that has seen a huge growth rate all around the world. The other variants of this disease are Alopecia areata where there are loss of hairs in the form of patches from the scalp. In case of Alopecia totalis the all the hairs from the scalp are lost. But in case of this disease Alopecia Universalis there is complete loss of the hairs from both scalp and the body. Although the exact cause of alopecia universalis is unknown, it is considered to be an autoimmune condition in which the person's immune system mistakenly attacks the hair follicles. An interaction between genetic and environmental factors is thought to play a role in the condition's onset. There is currently no cure for alopecia universalis, but sometimes hair regrowth occurs on its own, even after many years. In alopecia universalis there is loss of hair from scalp region, eyebrow region, body areas, eyelashes and in some cases from pubic and nose regions. Some patients complain of itching and burning sensation. The medical science researchers have not found any perfect solution to this problem. In this disease, one starts losing the hair from all parts of the body. Due to auto-immune reaction the hair falls. The immune system attacks hair follicles as a defense mechanism, which triggers hair loss. People affected by this disease are to suffer many things. Loss of hair is connected to other psychological issues as well. Patients suffering from this disease are at higher risk for other autoimmune diseases, like vitiligo and thyroid disease.

How is the treatment done ?

The treatment requires the doctor to first diagonise the presence of the Alopecia Universalis disease. This is done by observing the pattern of hair loss of the patient. It’s a very smooth, nonscarring, and patients have extensive hair loss. For some patients the doctors may ask for a scalp biopsy to confirm the presence of the condition. A scalp biopsy is a procedure that involves removing of a sample of the skin from the patients scalp and the sample is observed under a microscope.

For having an accurate diagnosis, the doctor may also perform blood test so as to rule out other conditions which can also cause hair loss, like liver disease, thyroid disease and lupus. Once the diagnosis is done, the patient treatment is to slow or stop hair loss. In some cases, treatment can restore hair to affected areas. The availbale treatment thus includes the following:

  1. Topical treatments: In this treatment the patient is given topical immunotherapies which are used to stimulate the immune system. For example Topical diphencyprone produces an allergic reaction to stimulate an immune system response. Due to this a redirection is done to the immune system response away from hair follicles which results in hair growth.
  2. Ultra violet therapy: For some patients ultraviolet light therapy is used to promote blood circulation which helps in activating hair follicles.
  3. Medication: Many medicines promise hair regrowth but one must consult the doctor before opting for medicines of his own. There are several recent studies showing that a class of medications known as JAK inhibitors, which includes Tofacitinib and Ruxolitinib, are effective in alopecia universalis. The hair growth may take six month time and in some case the condition may reverse even after hair growth.

Nobody can guarantee the regrowth of the hair but we may get a defined treatment to this alopecia universalis in near future. Many researchers are doing research work on alopecia universalis and they definitely will come up with some new treatment. The person suffering from this can opt for several things that will surely decrease the hair loss rates.

Some of the ways are listed below:

  • One can apply sun cream on the face and other parts of the body that are exposed to the sun directly.
  • Wearing eyeglasses and sunglasses for protection of eyes.

Who is eligible for the treatment of Alopecia Universalis?

Any person suffering from alopecia universalis can opt for the treatment. The treatment is mostly undertaken when there is a severe case of hair loss, and the hair does not grow back in the bald patches. It is better to wait for a period of about six months to one year before opting for the treatment as for 60 % of the individuals there are chances of hair regrowing back. The doctor will then examine the condition and will give the necessary medication and will let the patient know if a therapy is necessary.

Who is not eligible for the treatment?

If you are undertaking any severe medications, you might not be deemed fit for the treatment. Individuals who might be having allergic reactions to certain chemicals and drugs should not undergo the treatment for Alopecia Universalis . Also if you are opting for injections, you should check yourself that you are not suffering from any other medical conditions. Also if you are a heart patient do check with your doctor about the drugs you might have to undertake. It is wise to consult the doctor to test the eligibility.

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Are there any side effects?

.Some therapies may not suit the patient sensitivity level. The treatment may affect adversely and it can increase the hair loss too. The therapy can result in black patches on the body and can generate immunity problems too. They can increase the hair loss, decrease immunity aspects of the body. The side effects of the medicine Tofacitinib is upper respiratory tract infections, diarrhea, sore throat, headache, Vomiting’s, loss of appetitie, night sweat etc. Tell the doctor if you are pregnant or plan to become pregnant before taking this drug as it is unknown how it may affect a foetus.

What are the post-treatment guidelines?

Patients are required to protect themselves from sunlight. Wearing sunscreen lotions would help. The patients are required to take regular medications and regularly apply the oil to the affected part. They have to pay a visit to the doctor once a month. The doctor then records the progress of the treatment and tells to do changes if it is required.

How long does it take to recover?

The time is not definite. The treatment recovery time varies from the patient condition to condition and differs from the mode of the treatment opted for the patient. But it takes nearly 6 to 8 months for hair growth. Some cases have reported that they had to wait for a year for the treatment to get completed. But the treatment does not yield permanent result and thus the condition may again regenerate and the hair loss may start again after the treatment.

What is the price of the treatment in India?

The prices vary from hospital to hospital. The cost of the treatment is not less. It is always greater than 25000 INR. There may be an extra charge for medication and extra facilities in the hospital.

Are the results of the treatment permanent?

The results depend on how well you can take care of yourself according to the instructions. It is highly advised not to go for any therapy for the treatment of alopecia universalis unless instructed by the doctor. But the treatment does not yield permanent result and thus the condition may again regenerate and the hair loss may start again after the treatment.

What are the alternatives to the treatment?

The alternatives are quite common. Some of them are listed below:

  1. One can use home remedies for the treatment of alopecia universalis. There are many natural treatment ones can opt for. One can use natural oils.
  2. The patients can use several creams and several homoeopathic medicines to control hair loss.
  3. Korean red ginseng shows positive results in controlling hair fall and can be an alternative treatment.
  4. Onion juice for scalp, aloe vera etc have been proven to be other available alternatives.
  5. Aromatherapy can be sort to be an alternative therapy to control hair fall to some possible extend and is considered to be a safe therapy.

    It is always advised not to take therapy as the results are not sure and one is confirmed about the success of the treatment. The natural or home remedies are the best way for the treatment of alopecia universalis. This has no specific treatment. It is highly advised to research the treatment, consult a doctor and then opt for any treatment if the patient is found eligible. While there are research going on for the treatment of alopecia universalis.

References

  • Alopecia Universalis- GARD, Genetic and Rare Diseases Information Center. NIH, National Centre for Advancing Translational Sciences [Internet]. rarediseases.info.nih.gov 2017. [Cited 16 July 2019]. Available from:
  • Cho HH, Jo SJ, Paik SH, Jeon HC, Kim KH, Eun HC, Kwon OS. Clinical characteristics and prognostic factors in early-onset alopecia totalis and alopecia universalis. J Korean Med Sci. July, 2012; 27(7):799-802. [Cited 16 July 2019]. Available from:
  • Kassira S, Korta DZ, W Chapman L, Dann F. Review of treatment for alopecia totalis and alopecia universalis. Int J Dermatol. April 5, 2017; [Epub ahead of print] [Cited 16 July 2019]. Available from:

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Written ByDr. Amit Agarkar MD - Dermatology,FCPS - Dermatology, Venereology & Leprosy,MBBSDermatology
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Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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