Alopecia areata at the hairline

The front, temples, area behind the ears, or back edge of the scalp may be involved. A band-like pattern around the margin is sometimes harder to treat than a small isolated patch, so identifying its extent matters.

A smooth patch with preserved follicle openings can fit alopecia areata. However, tight braids or extensions may cause traction loss at the temples, fungal infection can produce scale and broken hairs, and some scarring disorders begin along the frontal margin.

A dermatologist checks the surface of the skin, broken or tapered hairs, eyebrow involvement, hairstyle tension, and symptoms such as itch, tenderness, or burning. Magnified examination can show details not visible in a mirror.

Pause tight hairstyles, heavy extensions, adhesive systems, and edge-control practices that pull or inflame the margin. Use gentle cleansing, minimise heat and chemical exposure, and shield bare areas from strong sunlight.

Photograph the hairline from the same angles with the hair relaxed. Note whether the patch expands, whether fine hairs return, and whether lashes, brows, nails, or other scalp areas change; these observations help guide the visit.

Arrange an assessment for a widening patch, a receding band without an obvious styling cause, or loss affecting eyebrows or eyelashes. Seek earlier care when there is pain, burning, spreading redness, thick scale, pus, crusting, or smooth shiny skin, because infection or follicle-damaging inflammation needs prompt evaluation.

Ask which examination features support alopecia areata, whether traction or scarring is present, and if any sampling is needed. Discuss how the thin skin and visible location affect the choice, placement, and monitoring of treatment.