Hair Loss in One Spot on the Head

A round, smooth patch without scale can be a presentation of alopecia areata. A scaly, itchy patch with broken hairs may occur with scalp ringworm. Hair pulled repeatedly by tight braids, extensions, or other styles can cause traction alopecia. Male or female pattern hair loss more often affects a broader pattern, while telogen effluvium usually causes shedding across the scalp rather than one sharply defined area. The appearance alone cannot confirm the cause.

Take a clear photograph and note when the spot appeared, whether it is enlarging, and whether there is itch, pain, scale, or broken hair. Avoid scratching, tight styling, and sharing combs, hats, or towels until infection has been considered. A clinician can inspect the follicles and scalp and decide whether testing or treatment is needed. Avoid applying steroid or antifungal products without advice.

Arrange prompt care if the patch expands quickly, becomes painful, swollen, crusted, or drains, or if fever occurs. Seek assessment for scarring, shiny skin, eyebrow loss, or several new patches. A child with a scaly patch or broken hairs should be assessed for scalp ringworm.

Ask what features distinguish alopecia areata, infection, pulling, and other causes; whether the follicles look scarred; whether household contacts need advice; and when you should return if the patch changes.