Alopecia universalis

Alternative names
Alopecia totalis; Alopecia areata

Alopecia areata is Hair loss of unknown cause, characterized by round patches of complete baldness.

Causes, incidence, and risk factors
The specific cause of alopecia areata is unknown. A family history of alopecia is present in about a fifth of all cases. Alopecia areata is occasionally associated with autoimmune diseases.

Alopecia may also occur as alopecia totalis with complete loss of scalp hair or as alopecia universalis with total loss of all body hair.


The primary symptom of alopecia areata is roundish patches of Hair loss on the head, with smooth, hairless scalp in the affected areas. Alopecia totalis involves the complete loss of all scalp hair, and alopecia universalis is characterized by the complete loss of all scalp and body hair.

Hairs that look like exclamation points are sometime seen at the edges of a bald patch.

Signs and tests
On occasion, a scalp biopsy may be performed.

No fully effective treatments are available. Typical therapy includes:

  • Topical corticosteroids (medium to very high potency)  
  • Subcutaneous (under the skin surface) steroid injection  
  • Ultraviolet light therapy

Irritating agents may be applied to hairless areas to promote regrowth

Expectations (prognosis)
Full recovery of hair is common. However, alopecia areata occurring at a young age, prolonged alopecia, or the presence of eczema (atopic dermatitis) often predicts a poorer outcome.

Permanent hair loss is a possible complication of alopecia areata.

Calling your health care provider
Call for an appointment with your health care provider if you are concerned about hair loss.

Johns Hopkins patient information

Last revised: December 5, 2012
by Potos A. Aagen, M.D.

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