Causes of a bald spot on the scalp

A smooth patch with intact-looking skin differs from an area containing scale, black dots, snapped shafts, redness, pustules, or surface shine. The border, symptoms, and visibility of follicle openings help distinguish hair that has broken from hair shed at the root or follicles damaged by disease.

In alopecia areata, immune activity can interrupt follicle growth and the condition often presents with smooth bald patches. Scalp ringworm can present with scaling, itching, broken hairs, or a tender inflamed swelling. Persistent pressure, tight styling, rubbing, or compulsive pulling produces patterns related to the repeated force.

Inflammatory scalp disorders may scar when follicles are damaged. Loss of follicle openings, a shiny surface, pain, burning, or redness centred around remaining hairs makes early evaluation especially valuable. Visual inspection alone at home may not separate these causes reliably.

Leave the area free of traction and friction, wash gently, and avoid dyes, relaxers, intense heat, and vigorous brushing until it is assessed. If the patch is flaky or inflamed, keep combs, hats, towels, and pillowcases for personal use. Images taken from the same angle can show whether the border moves.

At a medical visit, expect questions about onset, discomfort, contact with affected people or animals, styling, medicines, and hair loss elsewhere. Magnified scalp inspection and examination of hairs may be followed by fungal sampling or a small skin sample, depending on what is seen.

Have an enlarging, recurring, or unexplained patch assessed rather than repeatedly trying over-the-counter remedies. Same-day advice is appropriate for fever with scalp inflammation, rapidly spreading redness, pus, significant pain, or a boggy swelling. Book an early dermatology visit when the surface becomes shiny, follicle openings disappear, or hair loss accompanies burning or tenderness.

Ask whether hairs are breaking or shedding from the root, whether follicles appear scarred, and whether infection testing is advisable. Find out which treatments or styling habits to pause and what change should trigger an earlier follow-up.