Medically reviewed by Vicky Davis, FNP
Written by Our Editorial Team
Last updated 7/25/2021
Losing your hair is an unfortunate reality for many men as we age. Oftentimes, balding means the formation of a bald spot on the crown of the head (as well as near the temples, on the forehead or other places).
The top-of-head thinning of hair is one of the most commonly recognized places for a spot to form, but bald spots can happen anywhere — for more than one reason.
It’s a double bad news sandwich.
Yes, bald spots can form anywhere. Worse yet, the ones that form elsewhere can be indicative of more serious underlying medical conditions.
Whether you’re seeing some patchy loss of hair on your head or you’re seeing one specific part of your scalp (or your entire scalp, for that matter) much more than you used to, spot hair loss is a problem that shouldn’t be ignored.
To understand why spot hair loss can be so serious, it’s important to first understand what causes hair loss and why hair loss happens in general.
The first thing you need to know about hair loss is that it’s normal to lose hair every day. Your scalp sheds a certain number of follicles on average as part of the hairs’ natural life cycle.
That life cycle is important to understand. The lifespan of a hair follicle is best broken into three phases: anagen, catagen, and telogen.
Growth happens in the anagen phase, and 90 percent of the average person’s hair will normally be in that phase.
Catagen comes next, and you can think of it as a sort of retirement period for the hair: it’s not very productive, but it’s still hanging around.
The final stage, called the telogen phase, is when the hair could be considered dead. Hair in this phase has either already fallen out, or is about to do so shortly.
The good news is that this doesn’t account for much of your total hair — a normal person will have about nine percent of their hair in this phase unless something is wrong.
As you can probably guess, hair loss happens when more of the follicles than normal enter the telogen phase and remain there, sometimes indefinitely.
In some cases, this can look like even shedding across the head or even your entire body. But when it happens in patches, it can mean some serious issues are afoot.
Bald spots can be best categorized as symptoms of three types of hair loss. While this list isn’t comprehensive, it does represent the most common and plausible explanations for your spot hair loss.
This first type of hair loss is the most likely culprit, especially if your bald spot is on your crown. Male pattern baldness, also known as androgenic alopecia, is the result of hormonal damage to hair follicles caused by androgen as you age. It can start as early as your twenties, or much later in life. It may also be responsible for receding hairlines.
Unfortunately, there’s also research to indicate you might be predisposed to this type of hair loss, which means if you think you might be seeing thinning of your scalp hair, on your crown or the hair around your temples, a quick look at your family history might do some good — as well as talking to a healthcare professional, of course.
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The opposite of hormonal hair loss, traction alopecia is hair loss due to external, non-genetic factors — specifically, injury to the hair follicle.
Damage can come from a variety of sources, but the most common ones are hair styles and chemical irritants that damage the follicle over time. Two words: man bun.
But fashion aside, this one could also be psychological. Traction alopecia can also be caused by obsessive disorders that cause you to literally pull out your own hair.
The thing about alopecia areata is that it’s technically not a form of hair loss — it’s a symptom of an autoimmune disease.
Alopecia areata is caused by your immune system mistakenly attacking your hair follicles, which can result in spot hair loss on your scalp or all over your body.
Left untreated, it can lead to permanent hair loss.
Alopecia areata sounds very scary, so it’s best to dispel some myths from the start: it’s not contagious, it starts later in adolescence (often during a person’s teens,) and it can happen in cycles that are unpredictable.
According to the American Academy of Dermatology Association, hair loss from this condition can manifest as patches of hair loss, and patches can jump from one location to another — yes, they can heal and then start again elsewhere.
A variety of autoimmune diseases can cause sudden hair loss in the form of alopecia areata, including atopic dermatitis, hay fever, vitiligo, thyroid diseases, asthma or down syndrome.
Alopecia areata can also be caused by diseases including morphea, lichen sclerosus et atrophicus, lichen planus, pemphigus foliaceus, Hashimoto's thyroiditis, pernicious anemia, lupus erythematosus, hypothyroidism, endemic goiter, Addison's disease and diabetes mellitus.
And alopecia areata does have some genetic triggers. According to one study, some evidence suggests alopecia areata might be more likely if you’re hispanic or black.
This study was limited, however, in that it only observed women. Researchers also noted that more studies need to be conducted before we know anything definitive.
Treatments can include a variety of symptom-addressing options, including corticosteroids.
Scalp pigmentation, hair pieces or other cover-up options might be an effective solution for bald spots — you can learn more with our guide to How to Cover Up Bald Spots.
Another option for regrowing hair might be the generic version of Rogaine® (minoxidil), which has been shown to regrow and stimulate further hair follicle growth.
Minoxidil foam or liquid acts by increasing blood flow to the scalp, which can encourage currently dormant follicles to begin the hair growth cycle again.
While it’s not a cure for alopecia or baldness, studies, including one conducted over a 48-week period, showed that the minoxidil resulted in a total hair count increase of up to 18 percent — and noticeably thicker hair for some participants.
There are more options (albeit with less promising research behind them) on the market; for more, read How to Grow Hair on a Bald Spot.
Spot hair loss is a complicated issue, and as hair loss goes, it can signal some of the worst case scenarios.
Whether yours is crown-based or showing signs of an autoimmune condition, the smartest thing you can do to fortify your follicles is talk to a healthcare provider.
They will be able to help you diagnose the exact cause, and prescribe appropriate treatments, which might include attention to lifestyle and overall health concerns that might exacerbate your hair loss.
If you’re still trying scratching your head over your particular symptoms (don’t scratch — it’s bad for your skin), we have more resources available for you to learn more about hair loss, including articles on DHT and male hair loss, and how minoxidil and finasteride can work together to stop hair loss, which cover how these treatments work separately and in tandem to address the problem.
If you're ready to take action on your symptoms but don't know if we're the right company for you, check out some service comparison reviews like this on on the internet. We are confident you'll come back when you're ready for an excellent hair growth experience.