What should you know about hair loss in one spot?

A smooth, round or oval area without scale can be a presentation of alopecia areata. Scaly skin, broken hairs, crust, or swollen glands can occur with scalp ringworm. A patch near a repeatedly pulled style may fit traction alopecia. Picking, rubbing, burns, or other injury can also damage hairs locally. Pattern hair loss usually affects broader distributions, while telogen effluvium generally causes diffuse shedding, so a single sharply defined patch calls for a different assessment.

Avoid scratching, picking, tight hairstyles, extensions, and chemical treatments over the area. Photograph the patch with a ruler nearby for scale, and note its location, size, surface changes, and whether new spots appear. Do not share combs, brushes, hats, or pillows if infection is possible. A clinician can inspect the skin and hairs, check for inflammation or broken shafts, and select treatment based on the cause. Do not start finasteride treatment for a solitary patch without medical guidance.

Arrange an appointment promptly if the spot is enlarging, new patches appear, or the scalp is painful, warm, swollen, crusted, draining, or intensely itchy. Seek earlier care for fever, broken hairs with heavy scale, or loss of eyelashes or eyebrows. A scar-like shiny surface also warrants assessment because some forms of hair loss can injure follicles.

Does the surface and hair pattern suggest alopecia areata, ringworm, traction, or injury? Is the follicle still intact? Could anyone else in the household be exposed to an infection? What should I monitor while awaiting treatment?