What should you know about central scalp hair loss?

A widening part or gradually less coverage at the crown may fit female pattern hair loss or androgenetic alopecia. Round smooth patches can occur with alopecia areata. Scaling, broken hairs, tenderness, or swollen areas raise different possibilities, including scalp ringworm. Hair loss after fever, major stress, illness, childbirth, or a significant change in health may follow telogen effluvium. Repeated tight braids, extensions, or pulled-back styles can contribute to traction alopecia. The scalp may look normal in some forms, while redness, scale, pustules, or scarring need closer inspection.

Arrange a dermatology assessment if the thinning is continuing, spreading, or worrying you. Bring a list of illnesses, medicines, supplements, recent stressors, dietary changes, and hair practices. Take clear photographs in similar lighting so gradual change is easier to discuss. Use gentle washing, avoid tight styles and harsh chemical processing, and do not scratch or pick the scalp. Treatment depends on the cause; options may include addressing an infection or inflammatory condition, reducing traction, or discussing hair-loss medicines such as finasteride when clinically appropriate.

Seek prompt medical advice for rapidly expanding loss, painful or intensely itchy scalp, marked redness, pus, thick scale, fever, swollen glands, or areas that look shiny and scarred. Sudden patchy loss with eyebrow or eyelash changes also deserves assessment. Hair loss with fatigue, unexpected weight change, menstrual changes, or other new symptoms should be discussed because the broader history can help identify a contributing health problem.

Ask whether the distribution looks patterned, patchy, inflammatory, infectious, or related to traction; whether the follicles appear scarred; which examination or blood tests are useful; what improvement would realistically look like; and how long to continue a proposed treatment before reviewing it.