Patchy hair loss
Patchy hair loss describes defined areas with reduced or absent hair. Alopecia areata is one possible cause, but fungal infection, traction, hair pulling and inflammatory scarring conditions can produce similar patches. Treatment depends on the diagnosis.
What you may notice
- Round or irregular bald patches
- Broken hairs or short regrowth
- Scaling, redness or tenderness
- Pustules or a swollen scalp patch
- Patchy beard, eyebrow or eyelash loss
Why it can happen
Alopecia areata is autoimmune and usually does not scar follicles. Fungal infection can damage hairs and sometimes cause scarring. Repeated traction, hair pulling and inflammatory scalp diseases have different mechanisms and require different care.
What may help
Some alopecia areata regrows without treatment, but recurrence is possible and treatment may be appropriate. Scalp fungal infection requires oral antifungal medicine; shampoo alone is insufficient. Traction and scarring disorders need cause-specific care. Hair transplantation is generally unsuitable for alopecia areata.
When to consult
Have new bald patches assessed, especially in children. A painful swollen patch, pus, fever or rapidly worsening inflammation needs urgent review. Suspected scarring also deserves prompt assessment to limit permanent loss.
Evidence and sources
- DermNet. Alopecia areata [Internet]. Auckland: DermNet; 2023 [cited 2026 Nov 7]. Available from: https://dermnetnz.org/topics/alopecia-areata (new tab)
- Harries MJ, Ascott A, Asfour L, et al. British Association of Dermatologists living guideline for managing people with alopecia areata 2024. Br J Dermatol. 2025;192(2):190-205. doi: 10.1093/bjd/ljae385. (new tab)
- DermNet. Tinea capitis [Internet]. Auckland: DermNet New Zealand Trust; [cited 2026 Nov 7]. Available from: https://dermnetnz.org/topics/tinea-capitis (new tab)
- DermNet. Kerion [Internet]. Auckland: DermNet New Zealand Trust; [cited 2026 Nov 7]. Available from: https://dermnetnz.org/topics/kerion (new tab)
- National Health Service. Hair transplant [Internet]. London: National Health Service; [cited 2026 Nov 7]. Available from: https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/hair-transplant/ (new tab)