Sudden Hair Loss Patches on Scalp

Understanding causes and treatment for patchy hair loss

When to Seek Help:

Sudden patchy hair loss should be evaluated by a healthcare provider. While often benign, it can indicate conditions requiring treatment.

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Experiencing Patchy Hair Loss?

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What Causes Sudden Bald Patches?

Unlike pattern hair loss that develops gradually, sudden patches have specific causes:

1. Alopecia Areata (Most Common)

Alopecia areata is an autoimmune condition and the most common cause of sudden patchy hair loss:

  • Appearance: Smooth, round, coin-sized patches
  • Cause: Immune system attacks hair follicles
  • Who it affects: Any age, any gender
  • Prognosis: Many see spontaneous regrowth
  • Treatment: Corticosteroids, immunotherapy

2. Tinea Capitis (Scalp Ringworm)

  • Appearance: Scaly patches with broken-off hairs
  • Cause: Fungal infection
  • Symptoms: Itching, scaling, possible inflammation
  • More common in: Children
  • Treatment: Antifungal medications (oral usually needed)

3. Traction Alopecia

  • Appearance: Patchy loss where hair is pulled
  • Cause: Tight hairstyles (braids, ponytails, extensions)
  • Location: Often at hairline or where tension occurs
  • Treatment: Stopping the pulling; may be permanent if chronic

4. Trichotillomania

  • Appearance: Irregular patches with broken hairs
  • Cause: Hair-pulling disorder (behavioral)
  • Regrowth: Occurs when pulling stops
  • Treatment: Behavioral therapy, medication

5. Scarring Alopecia

  • Appearance: Smooth, shiny patches with no follicles visible
  • Cause: Destruction of hair follicles
  • Types: Various, including lichen planopilaris, frontal fibrosing alopecia
  • Important: Permanent hair loss; early treatment crucial

Key Differences to Note

ConditionPatch AppearanceScalpReversible?
Alopecia AreataSmooth, roundNormalOften yes
RingwormScaly, irregularRed, flakyYes with treatment
TractionAt tension pointsMay show folliclesIf caught early
ScarringShiny, no folliclesSmooth, no poresNo
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Get a Proper Diagnosis

Patchy hair loss has multiple potential causes. Our assessment can help narrow down possibilities, but a dermatologist visit is recommended.

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What to Expect at the Doctor

A dermatologist may:

  • Examine the scalp closely (possibly with dermoscope)
  • Take a scraping to test for fungal infection
  • Perform a hair pull test
  • Order blood tests
  • Take a scalp biopsy if needed

Treatment Options

Treatment depends on the cause:

  • Alopecia areata: Corticosteroid injections, topical treatments, JAK inhibitors
  • Fungal infection: Oral antifungal medication
  • Traction: Stop harmful styling practices
  • Scarring: Anti-inflammatory treatments to prevent spread

When to Act Quickly

Seek prompt medical attention if patches:

  • Are spreading rapidly
  • Are accompanied by scalp pain or burning
  • Show signs of infection (pus, severe redness)
  • Are accompanied by other symptoms

Conclusion

Sudden bald patches require attention, but many causes are treatable. Alopecia areata is the most common cause and often resolves on its own or with treatment.

Early diagnosis is important, especially to rule out scarring conditions that can cause permanent hair loss. Don't wait—see a dermatologist for proper evaluation and treatment recommendations.