Bald Spots and Thinning Hair: What to Know

Gradual widening of the part or recession at the temples can fit pattern hair loss, while shedding across the scalp can occur with telogen effluvium. A smooth, sharply defined patch, broken hairs, scaling, redness, or tenderness points toward other possibilities that need a closer scalp examination.

Hair density can change when follicles gradually produce finer strands, when many hairs enter the shedding phase together, or when inflammation or breakage affects a local area. Male pattern hair loss commonly presents with recession or thinning over the crown. Female pattern hair loss commonly presents with reduced density over the top of the scalp, often with a broader part. Telogen effluvium commonly presents with more widespread shedding rather than one clean-edged bald patch.

The appearance alone may not identify the cause. Recent illness, major stress, childbirth, restrictive eating, medication changes, tight hairstyles, and chemical or heat damage are useful details to share during an assessment.

Photograph the same areas in similar lighting every few weeks and note whether the change is patchy, diffuse, or concentrated along the hairline. Use gentle hair care, loosen styles that pull at the roots, and avoid repeatedly scratching or picking at the scalp. Keep a list of medicines and supplements, but do not stop prescribed treatment without speaking with the prescriber.

A dermatologist can inspect the scalp and hair shafts, perform a gentle pull test, and decide whether blood tests or a small scalp sample would clarify the cause. Treatment depends on the diagnosis; topical minoxidil, platelet-rich plasma treatment, and scalp micropigmentation serve different purposes and are not interchangeable.

Arrange a medical assessment if hair loss is sudden, forms distinct patches, continues to progress, or comes with itching, pain, redness, scale, sores, pus, or scarring. Prompt evaluation also matters when the eyebrows or eyelashes are affected, hairs break close to the scalp, or another person in the household develops a similar itchy or scaly patch.

Seek urgent care for rapidly spreading redness or swelling, significant scalp pain with fever, or signs of a severe reaction after using a hair or scalp product.

Ask which diagnosis best matches the distribution of hair loss, whether the follicles appear intact, and whether inflammation, infection, breakage, or shedding is present. You can also ask which examination or test would change the treatment plan, what improvement would look like, and how progress should be photographed or measured.