Bald Patches - Hair Loss & Hair Transplant Surgery Guide

In some cases the hair loss occurs in patches across the scalp, rather than being widespread. There are a number of possible causes for this.


A common cause of bald patches is a condition known as alopecia areata. This condition consists of small round patches of hair loss. A person may have one patch or several. The condition can affect people of any age, although it is most common in those aged between 15 and 30. It can affect hair anywhere on the body, and the patient may sometimes feel the area burning or itching. In the majority of cases the condition resolves itself spontaneously, and the hair grows back, although it may occasionally grow back white. Any discolouration will usually resolve within 12-18 months. Approximately 1 in 5 people who have alopecia areata may go on to develop more severe forms of the condition. Alopecia totalis is where all the hair on the scalp is lost, and alopecia universalis is where there is no hair on either the scalp or the body. The condition is thought to be associated with the immune system, but this is not certain.

Another cause of patchy hair loss is traction alopecia. This is due to hairstyles that put pressure on the roots of the hair, such as tight ponytails and braiding.

Trichotillomania is another cause of patchy hair loss, and is used to describe hair loss caused by people pulling or twisting the hair. As with traction alopecia, repeated pressure on the hair follicles can lead to patches of baldness, and it often affects the eyelashes as well as the scalp. The patches are not smooth, like in alopecia areata, and there are often strands of broken-off hairs.

Finally, patchy hair loss can be caused by a fungal scalp infection known as tinea capitis. It is common in school age children, and again the patches show broken off hairs.

A whole range of other diseases can cause patchy hair loss including sarcoid, systemic lupus erythematous (SLE), impetigo and sebarrhoeic dermatitis. These conditions have a range of other symptoms, as well as hair loss. Whilst these conditions are much less common, it is best to consult your doctor for any kind of hair loss to try and identify the cause.


The treatments for patchy hair loss depend on the cause of the problem.

Alopecia areata often resolves without any treatment after 6-9 months. However, steroid treatments, UV lights, and certain medications may be tried in some cases. Some more detail on the topical medications can be found in the treatment section of this article. Some people also use tattooing on the eyebrow area.

Traction alopecia can be treated by changing hairstyles so that less pressure is put on the hair follicles. The quicker this is done, the less likely it is that permanent scarring and damage will occur.

Similarly with trichotillomania, the only way to treat the condition is to stop the behaviour associated with it. Often this is just a matter of recognising the behaviour is occurring, but for some adults it may be compulsive in nature, and is therefore more difficult to stop.

Tinea capitis can be treated with antifungal treatments, and will usually resolve after the course of treatment.