A bald spot at the front of the head

The frontal scalp sits behind the hairline and may show diffuse loss, a focal gap or a part that has become more visible. Note whether hair is absent from the roots, finer than surrounding hair or snapped at different lengths, and whether the skin feels normal.

Slowly increasing visibility across the frontal scalp can fit patterned or diffuse thinning. An isolated, clean-edged smooth patch can be a presentation of alopecia areata. Loss centred where styling repeatedly pulls may reflect traction, while uneven short shafts point toward breakage.

Scalp disease becomes more likely when the area itches, hurts, flakes, crusts or develops bumps. Scalp ringworm can present with hair loss, scale and broken shafts. A shiny pale area with fewer follicle openings can indicate scarring and deserves specialist review because the goal is to protect remaining follicles.

Map the edges with photographs taken in the same position, on dry hair and in similar light. Record associated shedding, itch, pain and recent changes in health, medicines, diet or styling. Switch to low-tension hairstyles and gentle handling; avoid scratching, close clipping over a rash and unlabelled mixtures that irritate the scalp.

Plan a clinical examination if the area is clearly new, enlarging or difficult to classify. Inspection with magnification can show whether shafts are miniaturised or broken and whether follicle openings remain. Fungal sampling or selected laboratory tests may be used when the findings support them.

Contact a clinician soon if the spot expands quickly, additional areas appear, or the scalp develops persistent scale, tenderness, burning or a scar-like surface. Hair loss involving eyebrows, eyelashes or beard is another useful reason to arrange review.

Urgent assessment is appropriate for fever with scalp swelling, drainage, marked pain or redness spreading beyond the patch. If other people at home have itchy scaly scalps, mention that detail and avoid sharing hair tools until infection has been considered.

Ask what visible clues support the diagnosis, whether the process affects shafts or follicles and whether there is any sign of scarring. Clarify which tests could change management, when to expect a visible response and what would count as worsening. Discuss restoration only after the underlying cause and stability are established.