A bald spot on a woman's head: what to know

A smooth, clearly outlined patch can occur with alopecia areata. Scaling, broken hairs or tenderness can point toward a scalp disorder such as ringworm, while repeated tension from tight hairstyles can damage hair around stressed areas. A clinician can distinguish these patterns by examining the scalp and hair shafts.

The surface of the patch matters. Smooth skin without obvious scale has a different pattern from an area that is red, flaky, crusted or filled with short broken hairs. Location also helps: loss near points where braids, extensions or tightly secured coverings pull on the hair suggests ongoing mechanical stress.

Patchy loss may appear alone or alongside thinning elsewhere, eyebrow changes or nail changes. These details do not confirm a diagnosis, but they help a dermatologist decide whether close examination, a fungal sample or other evaluation is appropriate.

Avoid tight braids, extensions, harsh brushing and chemical processing over the affected area. Use gentle hair care, do not share combs or headwear, and avoid scratching or picking at scale. Take clear photographs in consistent lighting so changes in the border are easier to describe at an appointment.

Treatment depends on the cause. Anti-inflammatory treatment used for alopecia areata is different from antifungal treatment for scalp ringworm, and neither should be selected solely from a photograph. Hair transplantation is generally considered only after the diagnosis and activity of the hair-loss process have been assessed.

Book a medical assessment if the patch is enlarging, new patches appear, or the hair loss persists without a clear explanation. Seek prompt care for pain, swelling, pus, marked redness, fever, or a tender boggy area. Scaling and broken hairs also merit timely evaluation because a contagious fungal infection may need prescription treatment.

Ask which examination findings support the suspected cause, whether hairs are breaking or shedding from the root, and whether a scalp sample is needed. You can also ask which styling practices to pause, how treatment response will be judged, and what change should prompt an earlier follow-up.