Bald spots during pregnancy: causes and next steps

Pregnancy can alter hair growth and shedding, but a sharply outlined area, scale, broken hairs, soreness, or loss of follicle openings calls for a closer look rather than being attributed to hormones alone.

Alopecia areata commonly presents as a smooth, round or oval patch and may arise during pregnancy independently of hormonal shedding. Scalp ringworm can cause scale, itch, and hairs broken near the skin. Tight hairstyles, extensions, or repeated pulling can create a patch where tension is concentrated. A painful or burning area with redness, scale, or a shiny surface may indicate inflammation that could scar follicles. Nutritional or thyroid concerns more often affect shedding broadly, but a clinician can consider them alongside the scalp findings.

Show the patch to your obstetric clinician, family doctor, or dermatologist and state how quickly it appeared. Bring a list of prescription medicines, supplements, and scalp products. Do not start medicated lotions, tablets, essential oils, or supplements without checking whether they suit pregnancy and the suspected diagnosis. Choose loose hairstyles, mild shampoo, and gentle handling. If scale or broken hairs suggest infection, keep combs, towels, and head coverings separate until you receive advice.

Arrange an appointment when a bald spot is new, enlarging, recurring, or joined by additional patches. Seek prompt help for fever, pus, marked swelling, spreading redness, or a tender boggy area. Contact your maternity team promptly if hair loss occurs with feeling very unwell or other new pregnancy symptoms, since the overall clinical picture guides urgency.

Ask which diagnosis best fits the scalp appearance, whether testing is needed, and which treatment choices are suitable at your stage of pregnancy. Clarify whether a proposed medicine is topical or systemic, how the patch will be monitored, and whether the plan should change after delivery or while breastfeeding.