Bald spots: causes, care, and warning signs

Patchy hair loss can result from alopecia areata, a fungal scalp infection, repeated pulling, tight hairstyles, inflammation, or scarring conditions. The edge of the patch, broken hairs, scale, redness, tenderness, and whether the follicle openings remain visible all help a clinician distinguish them.

Alopecia areata often presents with a smooth round or oval patch and little surface scaling because the immune system targets hair follicles. Scalp ringworm can present with scaly patches, broken hairs, itching, or tender swollen areas; this fungal infection can spread between people and needs prescription treatment.

A shiny area with loss of follicle openings can point toward scarring hair loss, where early diagnosis matters because damaged follicles may not recover. Gradual thinning at the crown or temples follows a different pattern from a sharply defined bare patch.

Take clear photographs in consistent lighting so you can track the border. Handle the scalp gently, loosen braids or styles that pull, and pause harsh straightening, bleaching, and high heat. Do not share combs, hats, towels, or pillowcases if scale or infection is possible.

Avoid starting steroid creams, antifungal creams, supplements, or hair-growth products at random. Some scalp infections require oral medicine, while alopecia areata and scarring disorders need entirely different plans. Hair transplant surgery is generally considered only after the diagnosis and activity of hair loss are understood.

Book a dermatology assessment when a patch is enlarging, new patches appear, eyebrows or eyelashes are affected, or hair loss follows persistent traction. Prompt review is particularly useful when the scalp is painful, very inflamed, crusted, draining pus, or covered by thick scale.

Seek urgent care if scalp swelling is rapidly worsening, redness is spreading, fever develops, or you feel significantly unwell. A child with a scaly or inflamed bald patch should be evaluated promptly because a contagious fungal infection is one possibility.

Ask which diagnosis best matches the scalp examination and whether hairs, scale, blood tests, or a small skin sample would clarify it. Mention itching, pain, nail changes, recent illness, new medicines, family hair-loss patterns, styling practices, and affected household contacts. Ask whether follicles appear intact and what realistic regrowth can be expected.