Balding in one spot on the head

One smooth patch can occur with alopecia areata, whereas a flaky area containing snapped hairs can occur with scalp ringworm. An uneven patch can follow rubbing, pulling or sustained pressure. The cause cannot be confirmed solely from the fact that only one area is involved.

Inspect the surface in good light without scratching it. Normal-coloured, smooth skin points the assessment in a different direction from scale, crust, pimples or swelling. Tiny new hairs can indicate regrowth; hairs cut off at varied lengths suggest breakage. A glossy patch without visible follicle openings may represent scarring.

Consider what repeatedly touches the location, such as a tight style, helmet edge or habitual hand movement. Also look for patches in the beard or eyebrows and changes in the nails. These details help show whether the issue is confined to the scalp.

Mark progress with dated photographs taken from the same angle. Remove pressure and traction, choose mild shampoo and keep combs, towels and headwear to yourself when scaling is present. Resist shaving the spot repeatedly, because this can obscure broken hairs and irritate inflamed skin.

Request a clinical review if you cannot explain the patch, if it spreads or if it fails to show improvement. The clinician can inspect follicles under magnification and may collect scale or broken hair when fungus is considered. Do not begin someone else's prescription treatment: immune-related loss and infection require different medicines.

Get prompt assessment if the spot becomes very tender, swollen or soft, releases pus, or is accompanied by fever or expanding redness. Faster dermatology input is appropriate for sudden additional patches, eyebrow or eyelash involvement, or a scar-like surface where the follicle openings are no longer apparent.

Ask what features distinguish shedding from breakage, whether the follicles show scarring and whether a fungal sample would be useful. Clarify what improvement should look like, when to return and how to protect nearby hair while the cause is treated.