What should you know about smooth bald spot on scalp?

Alopecia areata often presents as a sharply defined area where hairs have fallen out and the skin looks smooth. Scalp ringworm may instead cause scaling, inflammation, tenderness, broken hairs, or swollen glands, although appearances can overlap. Tight styles or repeated tension can produce traction-related loss, sometimes with short broken hairs around the edge. A clinician may inspect the scalp and hair shafts, ask about recent illness and family history, and use testing when infection or another condition is suspected.

Arrange a medical assessment rather than applying steroid, antifungal, or hair-growth products without advice. Avoid tight braids, extensions, heat, and scratching the patch. Do not share combs, brushes, hats, or pillows if there is scaling or concern about ringworm, because infection can spread. Record when the patch appeared and whether it is enlarging; take a well-lit photo for comparison. Treatment depends on the diagnosis and the age, location, and activity of the loss.

Seek prompt review if the patch is rapidly enlarging, painful, crusted, draining, swollen, or associated with fever. Arrange earlier care for a child with scalp scaling and hair loss, or for loss of eyebrows and eyelashes. Sudden patchy loss deserves assessment even when the skin feels normal, because the visible pattern alone cannot identify the cause.

Ask which diagnosis best fits the patch, whether the scalp needs a fungal test, and whether nearby hair shows signs of active loss or breakage. Discuss treatment choices, expected monitoring, and whether a hair transplant would be unsuitable until the cause and activity are clear.