Signs of Alopecia Totalis

Hair may first fall in round or irregular patches and then become absent across the scalp. The scalp commonly looks smooth, without the scaling, heavy crusting, or scarring that can accompany other disorders. Eyebrow, eyelash, beard, or body hair may also change, but their involvement varies. Nail changes such as tiny pits or roughness can occur. Sudden or progressive hair loss has several possible explanations, so appearance alone cannot confirm the diagnosis.

Arrange a dermatology assessment so the scalp, nails, and remaining hair can be examined. Bring a timeline of shedding, photographs showing earlier stages, and a list of recent illnesses, medicines, or major physical stressors. Treat the scalp gently, limit pulling and harsh chemical processing, and use sun protection on uncovered skin. A clinician may discuss options including [JAK Inhibitor Treatment](/treatments/medical-dermatology/jak-inhibitor-therapy/), depending on the diagnosis and your health.

Book a prompt review if loss is rapidly expanding, the scalp is painful, very itchy, scaly, inflamed, or scarred, or you notice fatigue and other new symptoms. Urgent assessment is appropriate for sudden hair loss with facial swelling, breathing difficulty, or a severe medicine reaction. Emotional distress is also a valid reason to seek support while the cause is being assessed.

Ask what pattern of hair loss is present, whether tests or scalp examination are needed, what regrowth may look like, and which treatments or cosmetic supports are suitable for you.