Complete hair loss can occur at any age and affects males and females equally. Many people find alopecia areata totalis, complete hair loss on the head, and alopecia areata universalis, complete hair loss over the entire body, devastating. Alopecia areata is thought to be an autoimmune disease where the immune system attacks a person's own cells. Cancer treatment with chemotherapy drugs can also cause temporary hair loss. Hair may grow back on its own over time. Treatments for these conditions involve the use of a number of drugs that modify the immune system's response.
FDA Approval
The Food and Drug Administration has not specifically approved any drugs for use in treating alopecia areata, the National Alopecia Areata Foundation reports. Medical personnel do use a number of drugs to treat the condition on an "off-label" basis, which means that the drugs haven't been tested in clinical trials for the purpose prescribed and that there are no studies indicating their effectiveness.
Treatment Types
Most treatments for complete hair loss utilize drugs to suppress the immune system since an immune reaction appears to cause the disease. Corticosteroids, ultraviolet A light therapy, topical immunotherapy drugs and minoxidil may all be used to treat alopecia areata totalis or universalis. Corticosteroids are given by mouth or injected under the skin into a number of sites around the head every four to six weeks. Topical immunotherapy applies irritating chemicals to the scalp to produce an allergic rash that appears to stimulate hair growth.
Treatment Risks
Steroid injections should be done for no more than six months if no improvement has been seen, lead author Karyn Springer, MD, suggests in the July 1, 2003 issue of American Family Physician published by the American Academy of Family Physicians. Long-term steroid use, particularly when taken orally, can cause many complications, such as high blood pressure and blood glucose levels, increased susceptibility to infection and adrenal gland suppression. Topical immunotherapy can also cause a number of side effects that require monitoring by medical personnel very familiar with the drugs, Dr. Springer warns.
Results
Topical immunotherapy can result in new hair growth in 25 percent of cases, Springer states, but the continued use of the drug is required to maintain hair growth. If new hair growth occurs during corticosteroid treatments, hair loss may recur when the drug's use is stopped, the National Alopecia Areata Foundation explains.
Treatment Alternatives
For some people, no drug helps hair re-grow, or the treatments cause too many side effects. In these circumstances, some people opt to use wigs or hairpieces. Alopecia areata may also resolve spontaneously within six to twelve months, so some people may choose not to undergo treatment at all. Recurrence, however, occurs in 30 percent of cases, often in the same areas. Since chemotherapy-related hair loss is temporary, no hair regrowth treatments are used.
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