Bald Patches

A bald patch may look smooth and clearly outlined, or it may contain broken hairs, scale, redness, crusting, or tender skin. Some people notice itching, burning, soreness, or no scalp sensation at all. Hair can be missing from the scalp, beard, eyebrows, eyelashes, or another hair-bearing area.

The patch may stay in one place, enlarge, or appear alongside other patches. Note when you first saw it, whether hair is shedding elsewhere, and whether the skin is painful or scaly. These details help a clinician distinguish hair loss from breakage.

Arrange a clinical assessment for a new, enlarging, recurrent, or unexplained patch. Seek prompt care when hair loss comes with marked pain, pus, spreading redness, fever, significant swelling, or a scalp that is becoming smooth and shiny. Eyebrow or eyelash loss also deserves assessment because it can affect protection of the eyes.

The following causes are listed alphabetically, not by likelihood. A bald patch alone cannot identify which condition is present.

Alopecia areata can cause sharply defined areas of hair loss, sometimes with changes to nails or hair in other locations. Scarring alopecia can damage follicles and may leave smooth, shiny skin where hair does not regrow without treatment. Scalp ringworm can cause scale, inflammation, broken hairs, or tenderness. Hair pulling disorder involves repeated pulling or twisting that creates irregular areas of loss and broken hairs.

A clinician examines the scalp and the affected hair-bearing areas, asking about onset, progression, illness, medicines, styling practices, family history, and pulling or twisting behaviours. They may use magnification to inspect follicles and hair shafts, and may gently test how readily hairs shed.

If infection, inflammation, or another condition is suspected, the assessment may include a sample from the scalp or hair, blood tests, or a small biopsy. The choice depends on what the examination shows; not every person needs every test.

Treatment is selected after the cause is identified. Alopecia areata may be managed with clinician-directed medicines or injections. Suspected scalp ringworm needs medical treatment because cosmetic products alone do not clear an infection. In scarring alopecia, early treatment focuses on calming inflammation and protecting remaining follicles.

When hair pulling is contributing, behavioural support and treatment for urges or distress can reduce ongoing damage. Hair restoration options may be discussed after an underlying inflammatory or infectious process is controlled; a transplant is not suitable for every pattern of hair loss.

Handle hair gently, avoid tight styles and repeated traction, and limit harsh chemical or heat treatments when the scalp is irritated. Do not share combs, brushes, hats, or towels if a contagious scalp infection is suspected. Keep follow-up appointments so active inflammation or infection can be treated before more follicles are affected.

Related features can include scalp scale, itch, redness, tenderness, broken hairs, nail changes, or hair loss in the eyebrows, eyelashes, beard, or body. Recording these changes with dates and clear photographs can make progression easier to discuss at an appointment.

Some patches improve when the trigger is treated, while other patterns require ongoing monitoring to protect follicles and manage regrowth. The scalp’s surface, the duration of loss, and whether follicles remain active all influence the plan. A clinician can explain whether the priority is treating inflammation, clearing infection, reducing pulling, or discussing restoration.