One in 200,000 people experience the most severe form of hair loss: a complete loss of all hair on the body. This is not just complete baldness on the head. This condition, called alopecia universalis, is complete hair loss. The hair on the head falls out, eyebrows and eyelashes, facial hair, body hair—all gone, every last strand.
This does more than just affect appearance. The loss of the eyelashes in particular means this condition is not without consequences, since the eyelashes play an important role in protecting the eyes from damage. The touch-sensitive lashes warn of approaching dust particles or other tiny irritants, triggering the reflex of closing the eye. The lashes can also trap dust.
It is unclear what causes this hair loss. Alopecia aereata, the condition of which alopecia universalis is a form, is a continuum, with people losing various amounts of hair—from total loss to small patches on top of the head—but different forms may have different causes. Alopecia is believed to be an autoimmune disease, in which the immune system mistakes the hair follicles for diseased tissue and destroys them. People with alopecia universalis have thyroid problems and a skin condition called vitiligo more frequently than the general population, so these conditions might be related; patients with vitiligo have reported it developing into hair loss as well. Another possibility is that it is a genetic disorder, with hairless people carrying a hair loss gene that affects the entire body.
There is no known treatment for this condition. The is little research on the usual treatments for autoimmune conditions on hair loss, however, corticosteroids and other treatments for an overactive immune system have been used with some success. In some cases, the hair spontaneously regrows, but this cannot be predicted or controlled. Hair regrowth medications such as minoxidil work, but can’t prevent future hair loss.
In the summer of 2014, a doctor reported on a case of a man who had been administered a drug for rheumatoid arthritis—a drug also used to treat psoriasis, the condition for which the man had been referred to that doctor—and who as a result experienced a reversal of hair loss; is is hoped that this patient will be the first of a number for whom the drug is an effective treatment.