Bald spot at the hairline: causes and next steps

Its shape, the condition of the exposed skin, and whether short broken hairs remain are more informative than location alone. Early assessment matters when the area is expanding or the skin looks inflamed or scarred.

Tight braids, extensions, buns, headwear, or repeated styling tension can strain follicles along the front and temples. Fine broken hairs and tenderness may accompany this pattern. A smooth, clearly outlined patch can occur with alopecia areata, while scale, crust, itching, or snapped hairs raises concern for a fungal or inflammatory problem. Shiny skin, loss of visible follicle openings, or a steadily retreating irregular edge can suggest scarring and warrants prompt specialist review.

Pause hairstyles and accessories that pull on the affected edge. Handle the area gently, avoid chemical straightening or bleaching over irritated skin, and do not share combs, brushes, hats, or towels if scaling is present. Take clear photographs in consistent lighting so changes in the border can be compared. A dermatologist can examine the follicles and may sample hairs or scale when infection is suspected; treatment depends on the cause, so avoid using someone else’s steroid or antifungal medicine.

Arrange a timely appointment if the patch is enlarging, recurring, painful, very itchy, or accompanied by redness, pus, crusting, swelling, or hair loss elsewhere. Seek urgent care for rapidly spreading painful swelling, fever with a tender scalp, or swelling near the eyes. Children with a scaly patch or broken hairs should be assessed because scalp fungal infection may need prescription treatment and can spread to close contacts.

Ask whether the follicles appear intact, whether the pattern fits traction or alopecia areata, and whether a fungal test or other scalp examination would clarify the diagnosis. Also discuss which hair practices are safe during recovery, what change would indicate progression, and how the expected regrowth pattern will be monitored.