A bald spot at the crown of the head

The shape, speed of change and condition of the scalp are more informative than location alone. A clinician can distinguish reduced hair density from a sharply defined patch and check for inflammation, scale or scarring.

A normal whorl exposes a small area of scalp where hairs radiate in different directions and usually looks stable over time. Gradual pattern hair loss tends to produce widening visibility through the crown rather than an abrupt bare circle. Alopecia areata commonly presents with one or more smooth, well-defined bald patches.

Scale, itching and snapped hairs can accompany scalp ringworm. Redness, tenderness, pustules or a shiny area with fewer visible follicle openings deserve examination because inflammation or scarring can change treatment priorities.

Photograph the crown from the same angle, distance, lighting and hairstyle every few weeks. Note when you first noticed the area, whether shedding increased, and whether itching, flakes, discomfort or broken hairs appeared. This record is more useful than comparing unrelated mirror views.

Meanwhile, handle hair gently, avoid tight styles that pull around the crown, and limit harsh heat or chemical processing. Do not share combs, hats or pillowcases if there is scale or suspected fungal infection. Avoid starting several growth products at once, as irritation and overlapping changes can obscure what is happening.

Book a routine dermatology assessment if the crown is steadily becoming more visible, a discrete patch develops, or hair loss also affects other scalp areas, eyebrows or eyelashes. Prompt care is appropriate for pain, swelling, pus, crusting, spreading redness, fever or a boggy tender area. Children with a scaly patch and broken hairs should be assessed because a scalp infection can require oral medicine.

Ask whether the finding is a hair-density change, breakage or a true patch; whether follicle openings remain visible; and whether a fungal test, blood test or scalp sampling fits your examination. Discuss which treatment targets the suspected cause and how improvement or progression should be monitored.