Alopecia: Areata, Totalis, and Universalis
Alopecia areata is an autoimmune disorder which is characterized by hair loss. It is found equally in men and women. It is the
partial loss of hair in circumscribed (delineated) areas of the body — on the scalp it may result in round bald patches These
individuals have no obvious skin disorders or systemic diseases. The disease can occur at any age, even during childhood
and old age, although most cases have their first expression in the teen years or early 20s. Most people are in good health
otherwise, however there is an increased incidence of the following In people with alopecia areata: Down’s syndrome,
Addison’s disease, thyroid disorders, and vitiligo. Related forms of alopecia, based on location and distribution are as
- Alopecia totalis involves the loss of all facial and scalp hair.
- Alopecia universalis is the loss of all body hair.
- Alopecia postpartum is characterized by loss of significant hair following pregnancy and is usually temporary.
- Alopecia diffusa is, as implied, diffuse.
- Alopecia barbae affects a man’s beard area.
Early on in the lesion, hairs called exclamation mark hairs can often be seen at the edge of the bald patch(s). The hairs are
called thus because they look like exclamation marks. If hair is easily pulled out at the edge of the initial lesion, it means the
lesion is active and further hair loss can be expected.
Regrowth of hair may occur in some patients; and in others, the hair loss is permanent. Assurances cannot be given, although
there is always reason to hope.
Alopecia areata may last many years with some regrowth, or it may cycle through expression and remission. At first, hair
regrowth tends to be of very fine unpigmented hair later resuming normal color and texture. Regrowth may occur in one
region of the scalp while the hair loss develops in another area. Only 7% progress to complete hair loss.
Around 25% of people with alopecia also experience some degree of disruption of nail growth. This may involve all, some,
or just one of the nails. Nail dystrophy varies from a diffuse, fine pitting to severe alteration in a few cases.
Because this is thought to be an autoimmune disorder, hidden food allergies should be identified and those food avoided and
enzyme potentiated desensitization should be considered.
An alternative treatment is to administer all nutrients known to be needed by growing hair. This is best done under the
guidance of a physician trained in nutritional medicine.