dermatology

Alopecia Universalis: Causes, Symptoms, and Treatment Options

May 8, 2025

Table Of Contents

Alopecia universalis (AU) is a severe form of hair loss that goes beyond the scalp. Unlike other types, AU causes complete hair loss on the scalp and the entire body, including eyebrows, eyelashes, and body hair. It is a type of alopecia areata but differs from localized alopecia areata, which results in patchy hair loss, and alopecia totalis, which only affects the scalp. While AU can be emotionally challenging, new treatments may help some individuals regrow their hair. Additionally, seeking mental and emotional support can significantly improve the quality of life for those affected.

Symptoms of Alopecia Universalis

Alopecia Universalis (AU) often starts as alopecia areata universalis, affecting small patches of hair. As AU progresses, it can cause permanent bald spots on the scalp and lead to complete hair loss across the body. This advanced condition, also known as full body alopecia universalis, causes the loss of all body hair, including eyelashes, eyebrows, and even nasal hair.

Early Signs and Progression

  • Hair loss may begin with small bald patches.
  • Sudden shedding can occur, spreading rapidly across the scalp.
  • As it worsens, AU leads to the loss of all body hair, including pubic and facial hair.

Common Symptoms of Alopecia Universalis

If you notice widespread hair loss, it could indicate AU. Key symptoms include:

  • Loss of scalp hair (leading to alopecia totalis)
  • Loss of eyebrows and eyelashes
  • Loss of body hair, including arms, legs, and pubic hair
  • Loss of nasal hair, which may increase sensitivity to dust and allergens

Some individuals may also experience:

  • Itching or burning sensations in areas with hair loss
  • Increased skin sensitivity due to the absence of protective hair

Atopic dermatitis and nail pitting are not symptoms of alopecia universalis but may accompany alopecia areata. Researchers are actively conducting clinical trials to explore new treatments and participating in clinical trials of Alopecia Areata may offer access to innovative therapies for managing hair loss.

Causes and Risk Factors of Alopecia Universalis (AU)

Alopecia universalis (AU) is considered an advanced form of alopecia areata, a type of autoimmune disease. In this condition, the body's immune system attacks its own cells, specifically targeting the hair follicles, which leads to hair loss on the scalp and body.

Immune System Dysfunction

Alopecia universalis is believed to be an autoimmune disorder, where the immune system mistakenly identifies hair follicles as foreign invaders. As a defense mechanism, the immune system attacks the follicles, causing hair loss in areas such as the scalp, eyebrows, eyelashes, and body hair. This immune response is thought to trigger the hair loss associated with AU.

Genetic Factors  

While the exact cause of AU is still unknown, research suggests a genetic connection. Alopecia universalis often runs in families, indicating that certain genetic factors may make individuals more susceptible to developing the condition. If someone in your family has experienced AU, you may have an increased risk of developing it as well. Approximately 20% of individuals with AU have a family member with alopecia.

Autoimmune Diseases and Risk

People with alopecia areata may be at a higher risk of developing other autoimmune diseases, such as vitiligo and thyroid disorders.

The Role of Stress

While the exact relationship between stress and alopecia universalis remains uncertain, stress is believed to play a role in triggering the onset of AU in some individuals. However, more research is needed to confirm whether stress directly causes AU or exacerbates existing symptoms.

Diagnosing Alopecia Universalis

Doctors diagnose AU by examining the pattern of hair loss. They may perform a scalp biopsy or blood tests to confirm the condition. These tests help rule out other causes before recommending an alopecia universalis treatment.

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Treatment Options for Alopecia Universalis

Alopecia Universalis (AU) is a severe form of alopecia areata universalis that leads to complete hair loss on your scalp and body. While there is no guaranteed cure, several alopecia universalis treatment options may help stimulate hair regrowth or manage symptoms.

1. Medications for Hair Regrowth

  • JAK Inhibitors (Janus Kinase Inhibitors): These oral medications target immune system responses that cause hair loss.
  • Corticosteroids: These anti-inflammatory drugs, available as injections, pills, or topical creams, suppress immune activity to slow hair loss.
  • Contact Immunotherapy: Chemicals like diphencyprone (DPCP) create a mild allergic reaction to stimulate hair regrowth.

2. Light and Laser Therapies

  • Low-Level Laser Therapy (LLLT): Uses red light to stimulate hair follicles and improve blood circulation.

Potential Complications of Alopecia Universalis

Alopecia Universalis (AU) is not a life-threatening condition, but it can lead to certain complications that impact daily life.

Without body hair, individuals are more vulnerable to sunburn due to reduced protection against UV rays. The absence of eyelashes increases the risk of dust and debris entering the eyes, potentially leading to irritation or infections. Similarly, the lack of nasal hair makes it easier for germs, allergens, and bacteria to enter the respiratory system, increasing susceptibility to infections.

Beyond physical effects, AU can also have emotional and psychological impacts, affecting self-esteem and mental well-being. Seeking support from dermatologists, mental health professionals, or patient support groups can help individuals manage both the physical and emotional challenges of the condition.

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Coping with Alopecia Universalis: Finding What Works for You

Some people find comfort in wearing wigs or hairpieces. Others may prefer to go without. Regardless of personal choice, sun protection is essential. Wearing sun-protective head coverings, scarves, or hats helps shield the scalp from harmful UV rays, especially for those without hair.

Read More: Retrograde Alopecia: Signs of Hair Loss and Male Pattern Baldness

Can Alopecia Areata Be Prevented?

People often ask, can alopecia areata be stopped? Unfortunately, it cannot be prevented as it is an autoimmune condition influenced by genetic and environmental factors. However, managing stress, maintaining a healthy lifestyle, and seeking early treatment may help reduce flare-ups and severity.

What is Scarring Alopecia?

Scarring alopecia is a broad category of hair loss conditions in which inflammation destroys hair follicles and replaces them with scar tissue, leading to permanent hair loss.

Frontal Fibrosing Alopecia (FFA) is a specific type of scarring alopecia that primarily affects the hairline, causing progressive hair loss on the forehead and sometimes the eyebrows. It most commonly occurs in postmenopausal women.

Conclusion:

Alopecia Universalis (AU) is a rare autoimmune condition that leads to complete hair loss on your scalp and body. While the exact cause remains unclear, factors like immune system dysfunction, genetics, and stress may play a role. Though there is no definitive cure, several alopecia universalis treatment options, including JAK inhibitors, corticosteroids and alternative therapies, can help manage the condition. Furthermore, paid clinical research studies may provide access to potential treatment options for alopecia areata.

Frequently Asked Questions

Is Alopecia Universalis Dangerous?

No, Alopecia Universalis (AU) is not life-threatening. It is an autoimmune condition that causes complete hair loss on your scalp and body but does not affect overall health. However, it may increase sensitivity to dust and allergens due to the loss of nasal hair and eyelashes.

How Rare Is Alopecia Universalis?

According to the National Alopecia Areata Foundation, nearly 150 million people worldwide have some form of alopecia areata, while approximately 1 in 4,000 individuals have alopecia universalis.

Can Alopecia Be Caused by Stress?

Yes, stress can trigger or worsen alopecia, but it is not the sole cause. Alopecia totalis and Universalis result from an autoimmune response, where the body attacks hair follicles. However, emotional or physical stress may contribute to flare-ups in some individuals.

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