Alopecia Totalis: What Causes It and How to Cope with Hair Loss

This condition usually doesn’t happen overnight. However, in general, it is a rapidly progressing condition. Alopecia totalis starts like alopecia areata. In this condition, people often notice small bald spots on the scalp, which eventually spread and increase in size.

In some cases, especially when left untreated or triggered by stress or illness, these patches can merge, resulting in complete hair loss on the scalp. Alopecia totalis has a strong autoimmune connection. Our immune system is built to safeguard our body and fight against foreign and harmful invaders.

However, in autoimmune diseases, this system fails, and the body mistakes a healthy cell as an invader, in this case, hair follicles, and attacks them. This leads to inflammation that disrupts the hair growth cycle, ultimately causing hair to stop growing.

Why Does Alopecia Totalis Happen? Alopecia totalis is multifactorial, meaning it typically results from the combined effects of multiple factors. These factors can be both internal and external.

Here are some of the most common triggers and underlying causes

1. Genetics: If you have a family history or a parent, sibling, or grandparent with autoimmune diseases, then it’s more likely to be passed down in the family tree.

   Any autoimmune diseases like type 1 diabetes, thyroid disease, vitiligo, or rheumatoid arthritis can increase your chances of getting alopecia totalis. Fortunately, homeopathy can be an effective treatment for genetic hair loss

   Read more:

   • Can Diabetes Cause Hair Loss
   • Connection Between Thyroid Disorders & Hair Loss
   • Homeopathic Treatment for Vitiligo
2. Immune system dysfunction: You can also be the first in the family to get alopecia totalis if your immune system misfires. Your body will start attacking healthy hair follicles in this type of autoimmune disease.
3. Viral infections or illnesses: Sometimes, even something minor, such as the flu or the cold, can be the cause of Alopecia Totalis. It is not common for everybody. Instead, it occurs only in people whose immune systems remain overly active even after the flu is eliminated from the body.
4. Hormonal changes: Women can suffer from alopecia totalis due to shifts in hormone levels during puberty, pregnancy, post-partum, or menopause. This can also happen when they start or stop birth control pills, which can upset the immune balance. 
5. Stress: This can be emotional or physical. Stress, however, doesn’t cause alopecia by itself, but it is a known trigger. This is especially true if your stress is chronic, as stress raises cortisol levels. High cortisol levels can confuse the immune system, leading to excessive hair loss.

In some cases, external factors can also be the cause of alopecia totalis. These may be minor on their own, but when combined with genetic or immune system factors, they tip the body into alopecia. Here are some of the common ones: 

1. Air pollution and chemicals: Frequent exposure to industrial pollutants, synthetic hair products, or harsh hair treatments, such as chemical straightening, may be the reason.
2. Allergens: Dust mites, pet dander, or even reactions to skincare products can overstimulate the immune system.
3. Smoking: Tobacco is a well-known compound that triggers autoimmune reactions. Learn why you should quit smoking if you have an autoimmune disease like diabetes.
4. Certain medications: Some drugs like antidepressants, blood thinners, high blood pressure medicines, arthritis drugs, Parkinson’s treatment or chemotherapy can cause alopecia totalis.

It is important to note that alopecia totalis is not contagious and doesn’t indicate poor hygiene or nutrition on its own. It’s a complex internal process.

Read more - 

• Can Alopecia Areata be Treated?
• 5 Best Homeopathic Medicines for Hair Loss
• Homeopathic Treatment for Alopecia

Symptoms and Early Signs

Spotting the early signs of alopecia can help you slow down or even stop its progression. Alopecia totalis often begins as alopecia areata, which itself gets mistaken for general hair thinning or dandruff-related hair loss. Here’s what to look for: 

1. Patchy hair loss: This is the first sign of alopecia (i.e. Alopecia Areate), characterised by hair falling out in coin-sized patches. This can be without any pain or redness. These patches can appear on the scalp, beard or eyebrows. 
2. Progressive hair loss: If left untreated or triggered further, these patches of hair loss continue to grow larger and eventually merge. This leads to complete head baldness. This progression can happen gradually over several weeks or suddenly within a few days.
3. Loss of eyebrows and eyelashes: In more advanced and aggressive cases of alopecia totalis, facial hair-like eyebrows and eyelashes may also thin or fall out completely. This can affect eye protection as there is nothing to ward off dust and light.
4. Nail changes: Although this sign is not common to all patients of alopecia totalis, a study shows that about 40% of patients also see some nail changes. There can be pitting, ridges or brittleness of their fingernails. These signs sometimes occur even before the hair loss, so take them seriously.
5. Scalp sensitivity or itching: Some people experience a tingling, itching, or mild burning sensation in the scalp before the hair falls out. This is usually an indication of faulty immune activity around the follicles.

These early signs may not always point to alopecia totalis, but they shouldn’t be ignored. Consulting a dermatologist at the first signs of patchy hair loss gives you the best chance at slowing or reversing progression at the right time.

Will Alopecia Areata Come Back or Progress?

Suffering from alopecia areata can be depressing, and the thought of the condition reappearing scares everyone who has been through it once. Unfortunately, the answer isn’t black and white.

Read more: How to mentally overcome Alopecia Areata

Both Alopecia totalis and Alopecia Areata are often a relapsing and remitting condition, meaning it can come and go unpredictably. Hair might regrow in some places, but then a new patch of hair loss can appear in some other area on the scalp. 

In many cases, alopecia areata remains patchy but manageable. However, in severe cases, alopecia areata can progress to alopecia totalis (no hair on the scalp), which can further progress to alopecia universalis (no hair on the entire body). 

That being said, early treatment can help in some cases to reduce the chances of progression and support regrowth.

Diagnosis and When to See a Doctor

Noticing sudden hair loss in patches or, worse, on the entire scalp can be shocking. Many people initially dismiss it, blaming it on a disturbed sleep cycle, seasonal hair loss, work-related stress, or poor water quality and pollution.

However, if hair loss continues, worsens, or begins to affect your confidence or daily functioning, it’s time to consult a professional. Here’s when you should visit a doctor: 

• You see coin-sized bald patches or thinning in unusual areas.
• Hair is coming out in clumps, especially while combing or showering.
• Your eyebrows, eyelashes, or body hair are thinning. 
• There’s an associated burning, tingling or tickling sensation on the scalp.
• You have a family history of autoimmune disorders or alopecia.
• You are feeling anxious, confused, or emotionally distressed by the changes.

What happens at the clinic?

1. Physical examination: Your doctor will examine your scalp, eyebrows, eyelashes, and the rest of your body hair closely. They will check for signs such as patch shape, redness, scaling, or scarring. Your nails will also be examined for brittleness, ridges, or pitting, which are often associated with autoimmune diseases.
2. Medical and family history review: The doctor will ask you detailed questions about your health to gain a better understanding of your diagnosis. They may ask:
   • When did the hair loss begin?
   • Have you had any recent illnesses, infections, vaccines, or surgeries?
   • Are you under any mental or emotional stress?
   • Any family history of alopecia or any other autoimmune diseases?
   • Have you recently changed any medications or supplements?
3. Scalp biopsy: If the diagnosis is unclear from the physical examination, the doctor may recommend a scalp biopsy. This is a simple and quick procedure done under local anaesthesia. This usually helps the doctor differentiate between alopecia totalis and other types of hair loss diseases, such as lichen planopilaris or lupus-related alopecia.
4. Blood test: As alopecia totalis is an autoimmune disorder, blood tests are done to:
   • Check for thyroid dysfunction (TSH, T3, T4)
   • Rule out anemia ((CBC, iron, ferritin, B12)
   • Detect vitamin D deficiency
   • Screen for autoimmune markers (ANA, ESR, etc.)

Getting a proper diagnosis is more than just labelling your condition. You must get an early intervention for your type of alopecia to get the best and most personalised treatment.

Why Choose Dr Batra’s® for Treatment?

Dr Batra’s® is known for providing excellent hair loss treatment by combining homeopathy and trichology. You can find yourself with tailored treatment plans that will cater to your needs while integrating homeopathic remedies. 

They have also expanded their homeopathy clinics in Dubai and Abu Dhabi and to offer holistic hair loss management internationally.

How to Cope with Complete Hair Loss

Hair loss doesn’t just affect your scalp but also your confidence, identity, self-worth and emotions. That’s why it's very important to seek the right help to regain your confidence.

Emotional support

1. Talk to a counsellor or therapist: The right therapist can help you feel supported, decrease your stress and allow you to process the feelings of loss and low self-esteem.
2. Mindfulness and meditation: It can help reduce stress, improve mental health, and decrease autoimmune triggers.

Cosmetic solutions

1. Wigs and hairpieces: Modern wigs look incredibly real and are very comfortable to wear. Additionally, they are available in various styles, shades, and lengths, allowing you to create different hairstyles every day.
2. Scarves and hats: They are not only fashionable but are also great for protection against the sun and UV rays. They can look great in any outfit and style. But make sure your hat is clean, and that you don’t wear it too tightly.
3. Eyebrow tattooing or microblading: There are permanent as well as stick-on tattoo stickers available for the eyebrows. They can help restore facial definition and make you look more confident.
4. False lashes: These can be applied with glue or snap-on magnetic attachments. Either way, they are a great addition to your makeup routine, as they are easy to use and a great self-esteem booster.

Support networks:

It’s a great relief to know that you are not alone on this journey. Join a support group, whether local or online. Find your people and make friends in your community. Hearing others’ journeys can provide comfort, strength and inspiration. 

Living with Alopecia Totalis Life doesn’t stop with a diagnosis. Many people with alopecia totalis live a confident and fulfilling life with just a few adjustments. Here’s what you can do as well: 

1. Diet: Focus on anti-inflammatory foods, such as berries, turmeric, and leafy greens.
2. Avoid triggers: Identify and address the root cause of your problems. Say goodbye to stressors, allergens, or harsh hair products.
3. Gentle hair care: If you have partial hair growth, avoid heat and chemical treatments at all costs.
4. Practice body positivity: Yes, hair is a very important part of your look, but it’s not everything. Remember, you are not your hair. Redefine beauty for yourself.
5. Talk openly: Educate friends, employers, family, and teachers to help reduce stigma and foster understanding. There are so many famous advocates of alopecia totalis, areata and universalis all over the internet. Follow their journey, or better yet, become an influencer yourself. You never know who you may end up helping.

Conclusion

Alopecia totalis can feel like a big change, and it definitely is. But with the right information, treatment, and mindset, you can prevent it from taking control of your life. Knowing how to treat and cope with it is a very personal but highly manageable journey.

Remember, you are not alone. Seek help, explore treatment options, ask plenty of questions to your doctor and your community, and most importantly, be kind to yourself. There’s strength and beauty in resilience.