Alopecia Totalis Causes Total Baldness on the Scalp

alopecia totalis hairloss
A young woman with Alopecia is looking down and has her hand on her head. She appears to be discouraged.
iStock 1296628431 alopecia for hairloss site - Alopecia Totalis Causes Total Baldness on the Scalp
A young woman with Alopecia is looking down and has her hand on her head. She appears to be discouraged.


A prognosis of total baldness for an unknown reason and with no effective treatment is not easy to hear. Understand why it happens and then move on to either embracing the baldness or covering it beautifully.

Q. What is alopecia totalis?

A. Alopecia totalis is an offshoot of the autoimmune disease alopecia areata. It is diagnosed when total hair loss occurs on the head for no known reason other than autoimmunity attacking all the hair follicles on the head. The result is total baldness, although facial hair and body hair remain unaffected.

Q. What’s the difference between alopecia totalis and alopecia areata?

A. Alopecia areata is the name of the more common autoimmune hair loss disease that results in random bald patches on the head while hair on other parts of the scalp — and on the face and body — remains actively growing. Alopecia totalis affects the entire scalp, resulting in total baldness.

Q. What does “autoimmune disease” mean?

A. A healthy human immune system protects against viruses, bacteria and parasites that can attack the body. When the immune system mistakenly attacks its own hair follicles, in the case of alopecia totalis it is called autoimmunity and results in total baldness.

Q. Is alopecia totalis a genetic condition?

A. Experts believe there is a small correlation between genetics and alopecia areata in all its forms, including alopecia totalis. Researchers have found that one out of five people who have the symptoms have a family member also affected by this same type of autoimmune hair loss.

Q. Are there any other contributing factors to this type of hair loss disease?

A. Many experts have found that episodes of acute stress have precipitated the condition. Sometimes this type of hair loss is called telogen effluvium, or delayed shedding, caused by physical or emotional stress that shocks hair follicles into the resting and shedding phase; hair usually grows back in about six months later. In the case of alopecia totalis, hair loss on the head is total and the hair does not grow back.

Q. How can I get a proper diagnosis of alopecia totalis?

A. Alopecia totalis is considered a skin disease because it occurs on the skin of the hair, or scalp, and it is usually diagnosed by a dermatologist. While experts do not generally find rashes, hives or irritation from itching on the bald scalp, exposed scalp areas do require extra care, especially protective sun care.

Q. Is this a child’s disease or an adult disease?

A. Alopecia totalis is a disease that can strike any age group equally, although onset most often occurs in childhood. There may be a correlation between the age of onset and whether the condition is genetic: Current research has found that if onset begins after age 30, it is less likely a family member also is affected and that if onset of hair loss begins before age 30, it is more likely other family members as well are affected.

Q. Will the hair ever grow back?

A. Hair follicles remain alive and are ready to resume normal hair growth whenever they receive the appropriate signal from the body. In all cases hair growth can recur after many years of baldness and even without treatment.
Currently, there is no known treatment or cure for total scalp hair loss. The best bet, aside from embracing the baldness, as many men and women do, is to enlist the help of a qualified, experienced non-surgical hair replacement specialist, who can design a beautiful, natural-looking, medically necessary wig. Join the National Alopecia Areata Foundation at to learn more about the disease, to read about current research and treatments and to join support groups.