Types of Alopecia Areata – Patchy, Totalis, Universalis and Ophiasis

Let’s explore the different types and severity of alopecia areata.

Alopecia areata commonly starts as isolated patchy areas of hair loss on the scalp or beard.  But, depending on the type and severity of the disease, you may experience hair loss in other areas of your body.  Basically, anywhere that can grow hair could be affected including eyebrows, beard, legs, hands, arms, feet and even eyelashes.  More advanced type sufferers can experience the total loss of hair on the scalp (Totalis) and of the entire body (Universalis).

Overview of Alopecia areata

All forms of alopecia areata cause your own immune system to attack healthy hair follicles.  The resulting inflammation, which can cause minor irritation, reduces the size and productivity of the hair root and leads to hair loss. See our page on What causes or triggers Alopecia areata? for more information.

There are many factors involved here, depending on the type and severity of the disease, one sufferer’s experience may differ from the next.  The hair loss may affect different areas and the potential hair regrowth could be unpredictable and prone to reoccurrence over years or regrow fully in a few months with no repeat hair loss.

Types of Alopecia areata can range from mild to severe, sufferers can experience slightly different symptoms and therefore may require a different course of treatment.

Alopecia Types

Alopecia areata patchy

This is the most common form, displaying as one or more small oval or round hairless patches on the scalp, beard or other hair growing areas of the body.  The patchy type may progress into other more advanced versions, either alopecia totalis (entire scalp hair loss) or alopecia universalis (entire body hair loss), but this occurs to only around one in twenty of sufferers.

Alopecia areata patchy not totalis

Some early examples of Alopecia areata patchy – 1880’s

Alopecia areata is not a new disease, this picture was first published by George Henry in the 1886 publication ‘Photographic illustrations of skin diseases’.

You can see the telltale areas of hair loss, with some areas of pigment-free (colourless) hair left unaffected.

Persistent patchy alopecia areata – 

The term persistent patchy alopecia areata is reserved for where sufferers experience patchy scalp hair loss over many years, even regrowing and falling out again, without developing a more extensive type like totalis or universalis.

Alopecia areata barbae

This form of the disease is limited to the patchy hair loss in beards.  Sufferers will experience small hairless patches in the beard area of the face.  See our own page dedicated to the condition of Alopecia barbae.

Alopecia areata monolocularis

This is where baldness only occurs in one spot, which may be anywhere on the head.

Alopecia areata multilocularis

A type to describe multiple areas of hair loss.

Diffuse alopecia areata

Diffuse alopecia areata is where there is a sudden, unexpecting thinning of scalp hair.  It can look like other forms of hair loss including female pattern hair loss and telogen effluvium, therefore it is harder to diagnose.

Ophiasis alopecia areata

Ophiasis alopecia areata is tricky to treat.  It does not respond as quickly to medication – It shows as a unique pattern of hair loss, including the sides and lower back of the scalp (the occipital region) in a band like shape.

Alopecia totalis

Results in a total hair loss across the scalp.

Alopecia universalis

Where all body hair, pubic hair, face and head hair is lost, including eyebrows and eyelashes.  Universalis is a more advanced type of alopecia totalis.

Treatment and prognosis.

Currently, there is no cure for alopecia areata.  However, your hair follicles remain alive, so if the immune reaction is treated (even after many years) or goes away on its own and your environmental triggers are managed, hair may regrow and not fall out again.  At least, for as long as the treatment is maintained.

There are several treatment options, depending on what kind of alopecia areata is diagnosed by your Doctor, who will advise the appropriate treatment for your particular type of the disease.  Below are a few links to popular products, though these are not endorsed by alopeciaareara.co.uk.

Hairology Alopecia Areata Scalp Treatment Lotion

Helps to strengthen the hair follicle in bald patches.  Highly stimulating effective treatment for alopecia patches, bald patches and hair loss.  Increases hair’s volume, body and bounce resulting in stronger, healthier volumised hair.  Encourage good, strong new hair growth as quickly as possible.   Highly concentrated lotion, a little goes a long way.



Quintessence Forti5-S Hair Anti-Stress Dietary Supplement with Key Vitamins and Substances for Hair Regrowth and Recovery, 1 Month Supply – 60 caps.

Hair stress support dietary supplement; promotes hair regrowth and recovery.  With Phosphatidylserine for lowering cortisol and combating stress in cells.  Delivers key antioxidants and substances incl. Green Tea, Resveratrol, Curcumin, Beta-Sitosterol.  Might be beneficial for people suffering from Alopecia Areata (AA).  Gluten-free and Lactose-free