What should you know about little bald spots on the head?

A smooth, round patch without scale can occur with alopecia areata, an immune-related condition that affects hair follicles. A patch with scale, broken hairs, crusting, tenderness or swollen glands can suggest scalp ringworm, which may spread between people and needs medical treatment. Tight hairstyles, repeated pulling, scratching and local injury can also damage hair.

Look at the skin as well as the hair: redness, flaking, pain, pus or black dots from broken hairs are useful clues. [Bald Patches](/symptoms/bald-patches/) describes the symptom, while [Alopecia Areata](/conditions/alopecia-areata/) and [Scalp Ringworm](/conditions/scalp-ringworm/) cover two important causes.

Arrange a medical assessment if the patch is new, enlarging, recurring or joined by scalp symptoms. Do not share combs, brushes, hats or pillowcases while an infection is possible, and wash hair tools regularly. Choose loose hairstyles and avoid chemical treatments or vigorous scratching over the area.

A clinician may inspect the scalp and hairs, check other skin or nail changes, and take a sample if ringworm is suspected. Treatment depends on the cause; a hair transplant is not the first step for an active or unexplained patch.

Seek prompt care for painful swelling, pus, fever, rapidly spreading hair loss, extensive scaling, broken skin or a patch affecting eyelashes or eyebrows. Early review also matters when a child has a suspected infectious scalp problem, because untreated inflammation can injure follicles.

Ask whether the patch is smooth or inflamed, whether testing for scalp ringworm is needed, how to protect household contacts, and which treatment supports regrowth for the confirmed cause.