In short: hair lost in patches, rather than all over or in a pattern, has a short list of usual causes. The most common is alopecia areata (smooth, round patches). In children, a fungal infection of the scalp is common too, and it needs proper antifungal tablets. Patchy loss should always be checked by a dermatologist, because some causes can leave permanent scars if they're not treated early.
The usual causes
| Cause | What the patch looks like | Who | Key clue | Guide / action |
|---|---|---|---|---|
| Alopecia areata | Round, smooth, no scaling or redness | Any age | Appears in days or weeks; "exclamation-mark" hairs at the edges; beard or eyebrows too | Alopecia areata |
| Fungal infection (tinea capitis) | Scaly, sometimes itchy, broken hairs, may have black dots, pus or a boggy swelling | Mostly children; contacts | Others at home or school with similar patches; pets | See a doctor: needs oral antifungals; shampoo alone isn't enough |
| Hair pulling (trichotillomania) | Irregular patch, hairs broken at different lengths | Often teens and young adults | Urge to pull, often during stress or boredom | Doctor + behavioural therapy |
| Traction | Thinning where hair is pulled (hairline, temples) | Tight styles, braids, turbans | Hairstyle history | Hair damage and traction |
| Scarring alopecias (e.g. lichen planopilaris, discoid lupus, frontal fibrosing alopecia) | Shiny, smooth skin with no follicle openings; may be red, scaly, itchy or painful | Adults, often women | Itch, burning, slowly spreading | See a dermatologist urgently: lost hair can't regrow |
| Pressure / friction | Patch where the head rests or rubs | Babies, after long surgery, helmets | Location | Usually regrows |
| Secondary syphilis | "Moth-eaten" small patches | Adults | Other symptoms (rash, sores) | Doctor + tests |
Patchy hair loss in the beard
Usually alopecia areata (alopecia barbae). Fungal infection of the beard (tinea barbae) causes redness, bumps and pus. Both need a doctor. → Alopecia areata
Patchy hair loss in children
In children, fungal infection and alopecia areata are the two most common causes. Fungal infections spread, so check family members and avoid sharing combs, caps and pillows until treated. Always see a doctor for a child with hair loss.
Women with patches
The same causes apply. Patches at the hairline or temples can also be traction or frontal fibrosing alopecia (receding band of hairline, sometimes with eyebrow loss), which needs a dermatologist early.
What to do now
- Book a dermatologist. Patches need an examination, sometimes a scalp scraping or biopsy.
- Take photos with a ruler or coin for scale, so you can track whether patches grow or regrow.
- Don't self-treat with steroid creams before diagnosis. They can make fungal infections worse.
- Don't share combs, towels or caps until infection is ruled out.
See a doctor soon if you have: round bald patches that appear suddenly · hair coming out in clumps · redness, pain, pus, scaling or scarring on the scalp · hair loss with fever, weight loss, irregular periods, acne or new facial hair · eyebrow or eyelash loss · hair loss in a child.
Medical review pending: not yet reviewed by a dermatologist. Medical disclaimer
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