What Causes Alopecia Totalis?'

Day

Question: i’m just wondering, i’ve got alopecia totalis but what causes it to occur? how many treatments are there for it?

Answer: Hi Day, although Alopecia Totalis causes hair loss, it is actually an autoimmune condition. It happens when the immune system attacks the hair follicles causing the hair to fall out in clumps, in different levels depending on the type of alopecia a person has.

For instance, those with Alopecia Areata will experience patchy hair loss from anywhere on their scalp, whilst those with Alopecia Totalis will lose the hair on their scalp and generally their head too - including their eyelashes, eyebrows and any facial hair. Alopecia Universalis is the most extreme instance and causes complete hairloss from head to toe.

The precise cause of alopecia is currently unknown although triggers can include sudden shock, trauma and high levels of stress.

Researchers have recently discovered that the immune system is directly linked to the brain - a previously unknown fact and one which is being considered a huge breakthrough in understanding alopecia conditions, by the medical community. It is hoped that this new information will eventually lead to a cure or at least safe and efficient treatments for a range of autoimmune conditions.

As alopecia causes the follicles to prematurely enter the resting phase of the hair growth cycle, there is always a chance that the hair may regrow of its own accord. The trigger incident simply forces the follicles into the resting (Telogen) phase of this cycle, where they remain, halting normal hair production as they wait for a signal from the body to resume. Whilst there is no way of knowing if or when this signal will come, it is possible for people with alopecia to regain their hair naturally should this occur.

With regards treatment for alopecia totalis, there are currently limited options available, although there are a number of promising trials going on into potential treatments for alopecia.

The most common treatment accessible now is topical immunotherapy. This involves applying diphencyprone (DPCP) directly to the skin with a swab to induce, enhance or suppress the immune response. This is an on-going treatment that takes place around once per week and the dose should be gradually increased to build up the skin's tolerance as DPCP can often cause skin conditions such as mild dermatitis.

Despite being one of the better options, this type of treatment still has a low success rate - around 40% - so researchers are also looking into ways to improve topical immunotherapy. We do not treat Alopecia Totalis here at Belgravia so if you are interested in exploring your treatment options, we suggest you speak to your GP or dermatologist who should be able to help.