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Genetic and Rare Diseases Information Center (GARD)

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Alopecia universalis


Other Names for this Disease

  • Alopecia areata universalis
  • AU
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.

Overview

What is alopecia universalis?

What are the signs and symptoms of alopecia universalis?

What causes alopecia universalis?

Is alopecia universalis inherited?

How might alopecia universalis be treated?

What is the prognosis for individuals with alopecia universalis?

What is alopecia universalis?

Alopecia universalis (AU) is a condition characterized by the complete loss of hair on the scalp and body. It is an advanced form of alopecia areata, a condition that causes round patches of hair loss.[1] Although the exact cause of AU is unknown, it is thought to be an autoimmune condition in which an affected person's immune system mistakenly attacks the hair follicles.[2] Roughly 20% of affected people have a family member with alopecia suggesting that genetic factors may contribute to the development of AU.[3] There are currently no treatments known to be effective for alopecia universalis, but sometimes hair regrowth occurs on it's own, even after many years.[2][4]
Last updated: 11/20/2014

What are the signs and symptoms of alopecia universalis?

Alopecia universalis (AU) is characterized by complete loss of hair on both the scalp and body. Most people with AU do not have other signs and symptoms, but some may experience a burning sensation or itching on affected areas. In some cases, AU may be associated with other conditions such as atopic dermatitis, thyroid disorders, and/or nail changes (such as pitting).[5] Anxiety, personality disorders, depression, and paranoid disorders are more common in people with different forms of alopecia areata.[1]
Last updated: 8/26/2014

What causes alopecia universalis?

The exact underlying cause of alopecia universalis (AU) is not currently known. AU is a severe form of alopecia areata (AA). AA has been found to be an autoimmune condition; a person's immune system mistakenly attacks the hair follicles. Genetic studies have found that AA and AU are associated with several immune-related genes; however, they are thought to be complex disorders caused by multiple genetic and environmental factors that interact.[6] This means that although someone may inherit a genetic predisposition to the condition, they may not become affected unless something in the environment triggers the onset of the condition.
Last updated: 8/26/2014

Is alopecia universalis inherited?

Alopecia universalis is believed to be a multifactorial disease, which means it is caused by a combination of environmental influences and genetic predisposition.[2]  While a predisposition can be inherited and some affected people have a family history, the condition itself is not currently thought to be inherited. 
Last updated: 8/26/2014

How might alopecia universalis be treated?

While there is neither a cure nor drugs approved for its treatment, some people find that medications approved for other purposes can help hair grow back, at least temporarily. Since alopecia universalis is one of the more extensive types of alopecia areata, the types of treatment are somewhat limited. The most common treatments include cortisone pills and total immunotherapy.[2] 

There are possible side effects of cortisone pills which should be discussed with a physician. Also, regrown hair is likely to fall out when the cortisone pills are stopped. About 40% of people treated with topical immunotherapy will regrow scalp hair after about six months of treatment. Those who do successfully regrow scalp hair need to continue the treatment to maintain the hair regrowth, at least until the condition turns itself off.[7]

While these treatments may promote hair growth, they do not prevent new loss or cure the underlying disease.[2] For those who do not respond to treatment, wigs are an important option.[7]

Other treatments which may be used to promote hair growth include:[2]

Last updated: 10/30/2014

What is the prognosis for individuals with alopecia universalis?

The course of alopecia universalis is highly unpredictable, and the uncertainty of what will happen is probably the most difficult and frustrating aspect of the disease. Affected people may continue to lose hair, or hair loss may stop. The hair that has already been lost may or may not grow back.[2]
Last updated: 11/1/2013

References
  1. Chantal Bolduc. Alopecia Areata. Medscape Reference. March 19, 2014; http://emedicine.medscape.com/article/1069931-overview. Accessed 8/26/2014.
  2. Alopecia Areata: Questions and Answers About Alopecia Areata. National Institutes of Arthritis and Musculoskeletal and Skin Disorders (NIAMS). January 2012; http://www.niams.nih.gov/Health_Info/Alopecia_Areata/. Accessed 10/30/2014.
  3. Alopecia areata. MedlinePlus. 11/20/2012; http://www.nlm.nih.gov/medlineplus/ency/article/001450.htm.
  4. Types of Alopecia Areata. National Alopecia Areata Foundation. 2011; http://www.naaf.org/site/PageServer?pagename=about_alopecia_types. Accessed 7/11/2014.
  5. 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. Accessed 8/26/2014.
  6. Lee S., et. al. Exomic sequencing of immune-related genes reveals novel candidate variants associated with alopecia universalis. PLoS One. 2013; 8(1):Accessed 8/26/2014.
  7. Treatment for Alopecia Areata. National Alopecia Areata Foundation. 2011; http://www.naaf.org/site/PageServer?pagename=about_alopecia_treatment. Accessed 5/8/2012.
  8. Nucara S, Colao E, Mangone G, Baudi F, Fabiani F, Nocera D, Passafaro G, Longo T, Laria AE, Malatesta P, Amato R, Trapasso F, Perrotti N. Identification of a new mutation in the gene coding for hairless protein responsible for alopecia universalis: The importance of direct gene sequencing. Dermatology Online Journal. 2011; 17:3. http://www.ncbi.nlm.nih.gov/pubmed/21272494. Accessed 3/2/2012.


Other Names for this Disease
  • Alopecia areata universalis
  • AU
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.