Long-Term Prognosis of Alopecia Totalis and Alopecia Universalis: A Longitudinal Study with More than 10 Years of Follow-Up: Better than Reported

Dermatology. 2017;233(2-3):250-256. doi: 10.1159/000477458. Epub 2017 Jul 14.

Abstract

Background: In alopecia totalis (AT) and alopecia universalis (AU), the chance of full hair regrowth is known to be less than 10%. However, this information is based on a few older studies conducted in the 1950s and 1960s.

Objective: We investigated the current long-term prognosis of individuals with AT/AU.

Methods: A retrospective chart review was performed in patients with AT/AU between 1994 and 2005. Outcome data were collected by reviewing outpatient clinical files or by phone interviews. Finally, the long-term assessment of 70 patients with valid outcome data was performed.

Results: Twelve out of 70 patients with AT/AU (17.1%) had complete hair regrowth. Five out of 24 patients with AT (20.8%) showed complete hair regrowth, and 7 of 46 patients with AU (15.2%) achieved complete regrowth. Seventeen out of 70 patients with AT/AU (24.2%) reported hair regrowth greater than or equal to 90%. Thirty patients with AU (65.2%) remained in an alopecic state without improvement, while 5 patients with AT (20.8%) showed no hair regrowth.

Conclusion: Our results suggest that the long-term prognosis of AT/AU is more favorable than previously thought. However, the clinical burden of AT/AU is still substantial.

Keywords: Alopecia areata; Alopecia totalis; Alopecia universalis; Long-term prognosis; Prognostic factors.

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Alopecia / drug therapy
  • Alopecia / physiopathology*
  • Child
  • Child, Preschool
  • Female
  • Hair / growth & development*
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prognosis
  • Recovery of Function*
  • Retrospective Studies
  • Sex Factors
  • Time Factors
  • Young Adult

Supplementary concepts

  • Alopecia universalis