Bald spot on the head: causes, care and treatment

A smooth, sharply outlined patch can occur with alopecia areata, while scale, broken hairs or tenderness can accompany a scalp infection. Repeated pulling, tight hairstyles and skin inflammation can also damage or interrupt hair growth. Because these problems need different care, applying a random hair-growth product may delay the right treatment.

Look at the skin within the patch as well as the missing hair. Smooth skin without obvious scale may fit alopecia areata. Flaking, crusting, itch or hairs snapped close to the scalp can fit scalp ringworm, which requires medical assessment and prescription treatment. A shiny area with loss of visible follicle openings may indicate scarring and deserves prompt dermatology review because regrowth can become more difficult once follicles are damaged.

Photograph the spot in consistent lighting and note whether it is widening, itchy, painful or shedding short hairs. Use gentle shampoo, avoid scratching, and pause tight braids, extensions, harsh chemical processing and direct heat on the area. Do not share combs, hats or pillowcases when scaling or infection is possible. A clinician may examine the scalp closely, check other hair-bearing areas and choose treatment according to the cause.

Arrange an early appointment if the patch is expanding, more patches appear, or hair loss affects the eyebrows or eyelashes. Seek prompt care for pain, swelling, pus, thick crusting, fever, or a soft boggy swelling on the scalp. Children with a scaly bald patch should be assessed because scalp ringworm can spread and topical creams alone may not reach the infected hair roots.

Ask whether the follicles still appear intact, whether testing for fungus is appropriate, and what change would show that treatment is working. You can also ask how to use prescribed scalp medicine, what irritation to watch for, and whether your hair-care routine could be contributing. Hair transplant is generally considered only after the diagnosis is clear and the underlying process is stable.