Bald spots on a woman's scalp

Smooth round areas are a recognised presentation of alopecia areata. A patch with scaling, itching or broken hairs may reflect infection or another scalp condition. Tight hairstyles, extensions, chemical processing and habitual pulling can produce local damage, especially around areas under repeated tension.

Location matters. Loss along the hairline or where braids and extensions pull suggests traction, while a clean circular patch away from tension points has a different pattern. Irregular short hairs may represent breakage or pulling. Redness, burning, tenderness and a shiny surface raise concern about ongoing inflammation around follicles.

Recent childbirth, illness, nutritional difficulty and some medicines can be relevant to general shedding, but they do not explain every isolated spot. Tell the clinician about eyebrow or eyelash loss, nail surface changes, menstrual or thyroid symptoms and any family history of hair disorders.

Loosen hairstyles and pause extensions, relaxers, bleach or heat applied near the area. Handle the scalp gently and avoid oils or home mixtures that sting or conceal redness and scale. Photograph the part, hairline and patch so changes in density and size are easier to compare.

Book an examination when the cause is unclear, the area is enlarging or there are symptoms on the scalp. Depending on the appearance, a dermatologist may use magnification, check for fragile hairs or take a sample from a flaky surface. Treatment can differ greatly between traction, immune-related loss, infection and scarring inflammation.

Seek prompt medical care for spreading redness, severe tenderness, pus, fever or a swollen boggy patch. Do not delay a dermatology visit if follicle openings seem to vanish, the skin becomes shiny, several patches develop quickly or eyebrows and lashes begin shedding as well.

Ask whether the pattern shows breakage or loss from the root, whether styling tension has affected the follicles and whether infection needs to be excluded. It is also reasonable to ask what early regrowth looks like and which hair-care practices are suitable during treatment.