Bald patches

Baldness in patches, which is not in the typical male pattern, is usually alopecia areata. However, braiding and other tight hairstyles, hair pulling and fungal infection also cause bald patches.

Alopecia areata occurs in about 3% of people and affects men and women equally. It can occur at any age, but in most people it occurs between the ages of 5 and 40 years. The cause is not known. Most experts think it is an auto-immune condition, in which the body's immune system attacks the hair follicles by mistake. It is slightly more common in people with thyroid disease. There may be a link with stressful life events. About 1 in 5 people with alopecia areata says that other family members have the same problem, so genes are important.

The hair is lost completely from the patch, leaving a smooth, shiny scalp. A magnifying glass shows that the openings of the hair follicles are still present, but there are no hairs protruding from them. There may be short, distorted hairs at the edge of the bald patch. There may be only one patch, or there may be several. Sometimes there is a more diffuse moth-eaten appearance, rather than distinct patches.

Alopecia areata can be very distressing, but the good news is that the hair follicles are not permanently damaged so regrowth of hair usually occurs. Regrowth is unpredictable, but usually occurs in 6–9 months. At first the new hair may be white, but after 12–18 months the colour returns to normal. In some people the problem recurs after a few years.

In about 1 in 20 people with alopecia areata, the hair loss continues, so there will be total hair loss.

In a few people, regrowth can be temporarily encouraged with Regaine solution, but the effect lasts only while the lotion is being used.
Some doctors inject steroids into the scalp or prescribe steroid creams, but these only occasionally result in some regrowth and hair often falls out after treatment stops (MIMS Dermatology 2007;3:51).
Dithranol is a cream or paste made from tar, and is used mainly to treat the skin disease psoriasis. In some people it produces some regrowth of hair. It is rubbed into the scalp and washed off after a few hours. Dithranol is messy, and stains clothing.
Essential oils may help, according to research at Aberdeen Royal Infirmary, Scotland (published in the Archives of Dermatology in 1999). Patients massaged a combination of thyme, rosemary, lavender and cedar wood oils into their scalps at night, and then wrapped a warm towel around the head to encourage the oils to soak in. After a few months, 44% had growth of hair (compared with 15% of those using dummy oils).

Hot-combing with pomades. Some women apply a pomade to the hair and then use a hot-comb to straighten or style the hair. This can cause problems. The hot-comb melts the pomade, which drips down the hair to the root and into the hair follicle, where it can cause inflammation. The inflammation can damage the hair follicles and cause a bald patch, which can be permanent in severe cases. Hot-combing or using pomades alone is all right – it is using them together that causes the trouble.

Braiding and other tight hairstyles. Some hairstyles, such as braiding and corn-rows, pull the hair very tightly. This can result in a bald area, usually at the hairline around the forehead. If you give up this kind of hairstyle, the scalp usually recovers and the hair will grow normally, but the area can remain permanently bald.

Hair pulling. Children quite commonly develop a habit of pulling the hair; there will be a patch of hair loss with stubbly regrowth. Adults (particularly women) can develop a similar habit, which becomes a psychological compulsion and is hard to stop.

Fungal infection. In children, a bald patch is probably caused by a fungal infection. The bald area usually looks red and scaly. After the fungal infection is treated, the hair will grow again.

Other diseases. Some other diseases, such as systemic lupus erythematosus (SLE) and sarcoid, can cause bald patches, so it is worth discussing the problem with your doctor.

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Friday, February 26th 2010

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Comments on this article

Posted by Kirsty on 14/05/2012 at 12:44

Hi I'm Kirsty and I have hair loss, its bringing me down and I don't feel confident any more I have 3 patches 1 on the right hand side of my head 1 on the left side of my head and lastly 1 in the middle of my parting, I want my hair to grow back but my doctor said it falling out quicker than its grown, she says I will need a wig from the nhs, I feel sometimes that its effecting my work as I work with adults and children so I do get quite embarrassed about it. I feel that everyone is staring at me because people can see it. I just wish that I can get my wig sorted asap as i cant cope with this any more its effecting my confidence :(

Posted by Optional on 28/04/2012 at 06:46

im embarresed with my bald head.my TSH is slightly high,is a problem that caused this.can u plez help n i want to enjoy my life like other girls.

Posted by Optional on 04/04/2012 at 11:55

hi i am 15 years old and i have a bald patch on the top of my head. it itchs wich causes me to pull my hair off. i dont know how to stop this annd get my hair to grow back!

Posted by EEEE on 04/04/2012 at 12:07

Hiya, I have started with one small batches front of between middle as i noticed and after 6 months.... and it start spread into like 4 batches.. is there anything i can have it grow back? :S I don't really want lose anymore hairs... and how can i get it regrow.... and i get these pains and tingly in my head as well.... please help.

Posted by sunil on 27/03/2012 at 08:27

i have lost my hair very soon. could you please tel me, fron where i buy the hair petch in uk..

Posted by Optional on 15/03/2012 at 04:28

Im 21 and have to bald spot in the front of my head about around my temple what can i do?

Posted by A.R. on 22/02/2012 at 05:27

I have alopecia areata , bold patches in 3 places on my head, going to see a dermatologist soon. Doctors say it might be stress, I moved to Azerbaijan about 6 months ago. It's very depressing, the worst there is no support even from close people. Nobody gets it. I had it before but it was only 1 patch and small like 5 pence size. But now they are quite big like 3 2 pound coins in one place. Hope dermatologist will give me advice!

Posted by Optional on 12/02/2012 at 08:56

i normally have short hair and wear a fitted ball capp about every day and i got this baldness occurring on almost the top of my head and dont have any desease that i no of perfecty healthy exercise and eat right whats wrong idk?

Posted by BIKASH on 01/02/2012 at 09:36

sudden fall of hair from middel area of head.but fall of hair countinue.i have no family problem.plz give solution.

Posted by Optional on 27/01/2012 at 02:30

I have a bald spot in the top middle part of my head can I get any advice on how to grow my hair back

Posted by steve on 13/01/2012 at 07:42

i have a bold packet on the back of my head the size of a 1 pence peace have dark hair and never had problems going bald , gutted lol proper noticeable

Posted by Optional on 05/01/2012 at 12:38

i have a genetic problem that i have bald spot on my head so give me the solution

Posted by Optional on 03/01/2012 at 07:43

im 11 and have bald patches, everyone at school bullies me and i dont know wat to do. :(

Posted by franchezca on 29/12/2011 at 02:03

Im 35 and im losing my hair on just a part of my head what is happening to me

Posted by nitish on 25/11/2011 at 09:02

i am 17 and most of my hairs have grown white so suggest me ways to regain my black hairs.

Posted by Ayurveda_India on 05/11/2011 at 03:18

I have a solution! I was 17yrs old then. After a hair cut, I freaked out. I saw a 2cm diameter patch of hair lost on my scalp close to my left ear. Being an Indian, we trust Ayurveda and I was suggested to use apply Hibiscus (Use google to find about this flower). It is a red color flower and has a sticky gel like substance at the end of the flower. Thats you life saver. Rub that gel into your scalp everyday and let the gel dry on your skin. Trust me I was in tears when I saw hair growing back.It hardly took me 2weeks b4 I saw hair.I am 27 now have lost some hair on my chin. It feels so sick to hear people in the United States suggesting me to take steroids. Longing to back to India soon.

Posted by Yoh nee on 11/10/2011 at 04:34

Hi, i learned about my bald spot just last night when i had my haircut , and i freaked out because i was not aware of this. I almost cried when i saw it coz this is my hair and i loved them so much. But i remember, 2 weeks ago my friend applied GLATT (straightening cream) for me to get rid of the curly hair on my back, and thats the only reason i remember, good thing i have a long/thick hair till my shoulder. but I'm still embarrassed of what had happened. I dont want to lose my hair. My friend told me to use aloe vera gel. I hope this can help but please give me a remedy with this. I want my hair back pleaseeeeeee..............

Posted by Aqeel on 09/10/2011 at 09:42

Hi, I'm 37 male. I have 3 bald patches on my head & also 2patches on my chin. 2months ago doctor gave me stiroied injection 4pain relief & after 2weeks I noticed bald batches on my head. I went to doctor again last month but she said they don't know the reason for bald pathes & they don't have any treatment here in Finland. Plz help

Posted by Optional on 28/09/2011 at 04:46

i too have suffered with this wart and myterious bald spot on the back of my head..it hurt my comfidence at first but now it really dosnt bother me too much anymore but i never knew so many people are going through the same thing i am which is a breath of relief but i really dont know a solution all ive done is scrape it off but it comes back and i dont know what else to do th bald spot has gotten a little bigger if anyone has an update on what worked for them please let us all know

Posted by zulfikar ali rashid on 14/09/2011 at 06:34

my head is getting bold day by day i used mintop solution but not useful to me please give me some suggestion

Posted by Optional on 31/08/2011 at 03:34

its been 3yrs know since i have been suffering with bald patch in the back of my head.

Posted by Loyce Lloyd on 22/08/2011 at 05:11

I have bald spots on my scalp. When i was a teenager I used a classmates come that started sores in my head. my mother took me to a doctor, who told her to use acid and vaseline.That took my hair out , it never grew back and i still get sores. Is there anything i can use to get to treat my sclap and make my hair grow back.

Posted by Optional on 06/07/2011 at 12:28

Iam having bald patches in the back of my head and middle. its really freaking me, what shall i do to prevent it?

Posted by louise on 20/06/2011 at 07:12

I sufferend from major weightloss and since this, i have noticed my hair faling out more than it has ever been before. I was suffering from hairloss from the age of 11 and is still going. As the days are passing by, i am noticng a small bald patch in the middle of my hairline....i don't know what to do and i havn't been to the doctors yet! could you please give me some tips to reverse this suffering before i do go to the GP. thanks!

Posted by Optional on 04/06/2011 at 12:15

My mum discoverd a bald patch about the size of a 10p on the back of my head to the right, it has really freaked me out, my hair is the only thing i'm confindent about and i'm terrified help?

Posted by brian on 18/05/2011 at 05:03

I'm a 36 year old male , which I noticed for about the past 3 days now, a dime size shiny bald patch in back of scalp.... help

Posted by abdul on 08/05/2011 at 09:52

my hair losing very fast.i see my bald spot head.i have tension.pls tell me one solution.

Posted by Ben Harrison on 18/03/2011 at 08:02

Help, I have thick jet black hair and have never had an issue with hair loss, I also have not receeded. But a years ago a got a small bald patch the size of a 1p coin on the top of my head. This patch was smooth to touch like someone and burn my hair with a cigerette. then after 3mths it totally disappeared. Just two months ago , I notice a patch in the same place but this time it was the size of a golf ball but this time it is like baby hair. I can see my scalp but there is thin hair there. Can anyone help, ive tried washing my hair on a night before going to bed, so there are no products in it, ive chnage my shampoo, I dont understand my hair is fine everywhere. Its now having an affect on my confidence.

Posted by Ruben Corona on 11/01/2011 at 04:32

i have one big bald spot about 3 inches in the back of my right ear. a small on the left side of my ear about the same location but it's about 1 inch. what should i do if i haven been seen by a doctor?

Posted by Dieter Jordanl on 27/12/2010 at 08:43

With me, it is a matter of male pride, or vanity. I have been complimented on my beard and at my age...! I find it hard to cover a bald patch on my face, to the point of stressing out. It is a small area, but I'd like to look it natural. There are other reasons, but very hard to make them sound of importance. Can you suggest anything? Thank you

Posted by Optional on 01/11/2010 at 09:08

bald patches occur due to warts in head, too?

Posted by Optional on 05/10/2010 at 10:15

i started having thinning of the hair about 6 months after my baby was born after a a few months the hair grew back but now on the left side it as fell out again and it is worse than ever each week i can see it gettign futher back on my scalp.the doctor as gave me some steriod cream iv been using this for 3 weeks and it is still falling out, im so worried about this

Posted by levi on 18/09/2010 at 10:37

when i was in highschool i usually use hairgel almost everyday... by the time i'm about to enter college, i discovered some part in my head that is thinning in hair. now two small circles in my crown area and in the back of my head are bald and very smooth. is there a way for me to recover my loss hair? please help me..

Posted by meena on 02/09/2010 at 01:36

hi problem is i am lossing hair in patch i got big patch on my head i m doing at a moment aquaputner i cant see any any resuilt yet can u suggerst me any thing thanks very much

Posted by Optional on 13/08/2010 at 11:44

I have two small patches about the size of a ten pence peice. One at the back of my head and anther at the side of my ear. Then some patches small on my face at upper lip and chin which have been like that for about 6 months. No other areas affected

Posted by Jamie on 19/07/2010 at 04:20

Hello I've pulled my hair for a few months now and the bit i've pulled is at the back of the head on the left side just below the ear. I've tried not pulling but sometimes it just really hard. Its getting more noticeable and i broke down this morning and my mum has made me a doctors appointment. I just want something which can make my hair grow back again and i'm really going to try stop pulling it. Any idea what the doctor might say?

Posted by Queen on 06/07/2010 at 07:25

i have really thin hair. i have bald patches. my hair gets grasy eally quickly. and i am only 15. my friends have really nice hair, they always do it up, and have it down. i get jealous and very upset. what do i do? plz help x

Posted by MS AHMED on 05/04/2010 at 12:29

MY HAIR ARE SLOWLY REDUCING FROM LAST FEW YEARS IM ABSURVING PLEASE SUGGEST WHAT KIND OF DISEASES IS.

Posted by shaz on 28/01/2010 at 07:34

i am 19 years of age and have hair loss. i have losses around the back of my head where you can clearly see it is missing. i dont know what to do. i am only 19 years of age and it is scary to think what may happen to it in the future. any tips ?? please help

Posted by Farhana on 03/11/2009 at 09:01

I need to get a 50% Rogain for bald patches in my head

Posted by Anonymous on 19/09/2009 at 05:12

I have a small bald patch on the left side of my forehead in the region of hair growth. Also my hair is very thin and though i apply oil regularly on my hair,my hair does not remains set, it always falls down to my forehead and as a result I cant try out hairstyles. I want thick hair and regrow hair on the patch . Please suggest a remedy.