Category Archives: Hair Loss

What is Universal Hair Loss?

Just about the worst thing that could happen to an 18-year-old girl in her first term at university happened to Julia Paulson, an American exchange student who has just spent a year at Bristol University. All her hair fell out.

hair loss

Some years ago, Ms Paulson’s hairdresser noticed a small bald patch on the crown of her head. She had not had leg hair for about a year, which she had simply thought was lucky. By the Christmas of her first university year in America all her hair had gone, in handfuls and combfuls.

Ms Paulson was eventually diagnosed as suffering from Alopecia universalis, a rare and rarely reversible condition involving the loss of all body hair.

“It is amazing where you have hair,” she says. “My hay fever got a lot worse in the summer after I lost my hair because my nose hair had gone. Without eyelashes, my eyelids swelled up.”

Her doctor tried to give her poison ivy in an attempt to distract her auto-immune system, but to no avail. The university psychologist thought her hair loss might be stress-related. “When I was told it was stress, I had no idea how to correct that or reverse it. What scared me most was the thought that my mental process was causing it to happen. People had been telling me to relax for years.”

Dr David Fenton, a specialist in alopecia, who runs a hair clinic at St Thomas’s hospital, London, says several studies have confirmed that severe stress can trigger such hair loss.

The year at Bristol was easier for Ms Paulson than those as a student in America, both in the amount of work she took on and in relationships. “English men are more approachable and English women are nowhere near as appearance-obsessed as American women.”

Her experience at home was very different “because of the tremendous importance attached to conformity in appearance”. Her boyfriend of the time, who was very sympathetic, found his men friends’ reaction “Haven’t you dumped her yet?” heartless.

When she first lost her hair Ms. Paulson took to wearing a baseball cap. She tried using Provillus and Scalp Med (please see for more information). But they didn’t work. Boys stopped sitting next to her in class. It took her three years to build up the courage to go swimming again.

provillus women

She has had to learn to cope with people’s reactions. “If you sit on a bus with no hair people react either as if you are a punk or as if you are bald as a result of chemotherapy and are therefore dying.”

She confided her attacks of despair in a woman friend who has cancer. The friend helped her emotionally and, after making sure that she had tried Provillus first, dragged her along to buy a wig. It took her a long time to start wearing it. She finds it emotionally bothersome to feel “the stab of fear that someone might walk in on me when I’m not wearing it”.

According to Ms. Paulson the wig industry in America is geared to the permanent wig. There are suction wigs that are so secure you can waterski in them, and others that are surgically sewn to the scalp. The procedure has to be repeated every six months, and carries with it the risk of infection. Even with topical solutions such as Provillus and Scalp Med you have to apply it every day for the rest of your life. Neither solution is yet available in Britain. Hair weaving and implanting techniques are only possible for people with some hair.

Ms. Paulson is not interested in taking Provillus and Scalp Med anymore. “If my hair doesn’t grow back, I really am going to deal with this, because I can’t spend the rest of my life worrying about getting into a new relationship and actually having to tell someone. I feel really distanced from my face. Looking at myself in the mirror is always a surprise.”

Her experience, of total hair loss, is rare. Dr. Reginald Harris, a dermatologist at London’s Royal Free Hospital, reports that 2 percent of all outpatient dermatology cases are suffering from alopecia-areata, partial hair loss that will regrow in time if they use Provillus and Scalp Med. Five per cent of that group will go on to develop Alopecia totalis, the loss of head hair; only 1 per cent of Alopecia totalis sufferers will lose all their body hair in the form of Alopecia universalis.

After three years of total hairlessness, Ms. Paulson does have small tufts of hair growing on her scalp and is optimistic. “Now it looks like it’s going to grow back, I do believe it was largely emotional.

“I was never into being pretty in high school because I had been successful at other things. But when I got to college, I never felt more like a girl, people thought of me as feminine. Before I lost my hair, I took refuge in academic activities. Prettiness can be a refuge, too.”