Quarter-size bald spot on head: what to know

A smooth, clearly outlined patch without scale or broken hairs can be a presentation of alopecia areata, an immune-related condition affecting hair follicles. A patch with scale, tenderness, crusting, or broken hairs may fit scalp ringworm, which needs medical treatment. Tight hairstyles, repeated pulling, chemical processing, or rubbing can also injure hair over time. The size alone does not identify the cause.

Take a clear photograph in good light and note when you first noticed the change. Avoid scratching, harsh chemical products, tight hairstyles, and sharing combs, hats, or pillowcases until infection has been considered. Arrange a clinician or dermatologist visit, particularly if the patch is enlarging or new areas appear. Treatment may involve a scalp examination and, when needed, testing before medicine is chosen.

Seek prompt medical advice if the scalp is painful, swollen, draining, very itchy, or covered with crusts, or if you feel unwell. Arrange assessment soon when hair loss is spreading quickly, eyelashes or eyebrows are affected, or the skin looks scarred. These features can point to inflammation or infection where early treatment matters.

Could the surface appearance suggest alopecia areata, infection, or traction? Do you need to examine hairs or take a sample? Which hair practices should I pause? What changes should prompt an earlier review?