What are the Treatments for Alopecia Totalis?

Alopecia totalis, or alopecia areata totalis, refers to the complete loss of hair from the scalp and affects 5 percent of all hair loss patients. It is an autoimmune disorder. The hair follicles remain alive, but the immune system's white blood cells attack them, preventing hair growth. Since the follicles stay alive, alopecia areata totalis may resolve without medical intervention; hair growth may resume on its own.

Hair loss treatments for alopecia focus on removing the immune system's interference, prompting follicles to resume normal hair production. Medications established for treating other conditions, steroids and topical irritants produce mixed results.

Established Medications

• Minoxidil, marketed under several brand names and found in several hair loss products, can be purchased as a foam or solution for direct application to the scalp. According to the Mayo Clinic, topical forms of minoxidil don't require a prescription.

  The pill form of Minoxidil, to be taken orally, requires a prescription relaxes blood vessels and was originally used to lower blood pressure. Hair growth is a side effect. Other side effects associated with oral use of minoxidil are chest pain, weight gain, and a rapid heartbeat. Follow the doctor's instructions carefully while using minoxidil.

Steroids

• According to DermNet NZ, steroids may be prescribed in cream or pill form. The cream and gel forms, applied topically or to the skin, are the mildest steroid treatments and usually tried before moving on to more aggressive steroid treatments. You may experience side affects, like excessive hair growth on other parts of the body, or acne.

  In some cases, doctors will inject steroids directly into the hair follicles. These are not performance enhancing steroids, but corticosteroids, like triamcinalone, which remove wayward immune cells and ease inflammation, allowing hair growth. Several injections are necessary to treat each area.

Immunotherapy

• Immunotherapy uses the body's own chemical responses to treat diseases and disorders. The doctor applies a substance known to create an allergic reaction, to the scalp. The body produces chemicals to fight the irritating substance, or allergen. Hair follicles, stimulated by the reaction, produce new hair.

  While the allergen may stay where applied, the reaction may spread to other areas. The body's response may also cause swollen lymph glands, swelling at the application site and darkening of the skin, or hyperpigmentation. Fortunately, the treatment need not involve needles and may be attractive to people who are uncomfortable with injections.

Alternatives

• As with other disorders, home remedies and alternative treatments are available. Massaging essential oils like rosemary, cedarwood and lavende into the scalp may provide relief. A study performed in 2007, tested the effects of garlic gel applied with betamethasone valerate. While results were promising, betamethasone valerate is still a topical steroid, meaning the treatment involves a pharmaceutical substance.

  Hypnosis may also help reverse alopecia areata totalis. A study, published in 2006, focused on its use as complementary treatment, not a primary treatment. After 5 years, results are mixed and a formal investigation is needed. While hypnosis may not be completely responsible for the hair growth seen in the study, the resulting anxiety management may be beneficial, making primary treatments more successful.

Considerations

• According to the National Alopecia Areata Foundation, treatments for alopecia totalis work for only 40% of people and no treatment successfully reverses hair loss when over 50% of scalp hair has been affected. The FDA has approved no medications for treating hair loss.Treatments involving existing medications, like Minoxidil, take advantage of side effects that might otherwise be troublesome.

  Ask your doctor how the pill form of a medication will affect any current medications you are taking, and keep track of unusual symptoms, once treatment begins.

Prevention/Solution

• Alopecia areata, the patchy loss of scalp hair, leaves clumps of hair behind. Alopecia areata totalis involves the whole scalp without patches of hair left behind. If you have noticed unusual hair loss, seek immediate medical advice. As stated earlier, no treatments have been proved successful for alopecia totalis, but you may slow or reverse hair loss with treatments for the less extensive alopecia areata.