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Bald spot on the back of your head? Here's what could be causing it

Hair loss and thinning is a common condition with many causes.

Written by
Sophie Overett
Medically reviewed by
Last updated
April 18, 2024
min read
Bald spot on the back of your head? Here's what could be causing it
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The thing about medical conditions that impact the way we look is that they can feel both widespread and deeply personal. And, while we know that hair loss is a common condition with many causes, it doesn't make the experience of thinning hair any easier.

Thinning at the temples, or a bald spot on the back of your head can feel especially visible too and impact your confidence and your sense of self.

As a result, working out what’s causing it and how to treat it can feel like a priority. But never fear, Pilot’s got your back! Let’s take a look at the ins and outs of alopecia areata and how you can address hair loss to feel like your best self again.

What is alopecia areata?

Otherwise known as focal hair loss, alopecia areata is a complex autoimmune disease that involves patchy hair loss on the scalp [1].

It’s generally understood to be the most common form of hair loss and it typically develops in children but can affect people of any age and of any sex, race or ethnicity [2].

Alopecia areata attacks your hair follicles, and while it doesn’t kill them, it does render them dormant [3]. In other words, it deliberately stops a hair follicle from growing hair, and the result is that hair typically falls out in small, circular patches across the scalp, and sometimes from the beard area in men, eyebrow hair or eyelashes [4].

This slightly varies from person to person, but generally speaking, hair will break off in short, broken hairs, or ‘exclamation point’ hairs that are narrower at the bottom than they are at the top [4]. This is often accompanied by further hair loss symptoms.

Symptoms of alopecia areata

Alopecia areata can involve more than just sudden hair loss and the development of patchy bald spots. While these are most often the obvious signs of the condition, other symptoms can include:

  • Nail abnormalities, in particular, nail pitting, thinning or thickening, or ridges [1]
  • Hair changes such as new hair growth appearing as white or grey at first, but regaining colour over time [4]
  • Additional bald patches develop on different parts of the scalp or beside the existing one, facial hair loss or more extensive hair loss generally leads to alopecia totalis or total hair loss [4]

What causes bald spots on the head?

Knowing what it looks like is one thing, but knowing what causes it can be quite another. Can you simply develop alopecia areata at any point? And, is there anything you can do to prevent it?

The answers to both these questions are unfortunately not straightforward as research on these sorts of autoimmune diseases is still being conducted. That being said, we do know that there are 3 major factors when it comes to balding.

Genetics and family history

As with many medical conditions, genetics come into serious play when it comes to any sort of hair loss or balding.

Some studies show that up to 42% of alopecia areata cases stem from a family history of the condition, and genome-wide association studies have found numerous connections between genetic DNA and alopecia areata [1].

This coincides with many other forms of alopecia, in particular androgenetic alopecia (otherwise known as male pattern baldness and female pattern hair loss) which has also been found to run in family lines.

Existing health conditions

Increasingly, links are being found between alopecia areata and other autoimmune diseases and health conditions.

Recent studies in particular have found a direct link between the way some people lose hair and illnesses such as asthma, type 1 diabetes, allergic rhinitis, atopic dermatitis and thyroid disease [2]. In these cases, patchy hair loss can be symptomatic of these underlying conditions, and treatment of said conditions should improve hair growth.

Environmental factors

Environmental factors have also been indicated to play a significant role in hair loss and the development of alopecia areata.

Major stress events have long been associated with thinning hair, temporary hair loss and androgenic alopecia, but factors such as infection, diet and even helmets or hair pulling causing traction alopecia have been affiliated with the development of spot baldness and alopecia areata [4].

Can you regrow hair on bald spots?

While there's no known cure for alopecia areata, there are treatment options available that suggest you can increase hair growth and even grow new hair.

As alopecia areata only renders the hair follicles dormant and doesn’t kill them, hair can and does sometimes spontaneously regrow [3].

Recent studies suggest that between 34-50% of patients experiencing bald patches can regrow hair within a year, while another 14-25% will regrow some hair, but not all [1]. In all these cases though, support through hair loss treatments is encouraged, as it’s rare for the hair to regrow on its own.

The people who have the most luck with regrowth though are people with less extensive hair loss, later age onset, no changes to their nails, and no family history of alopecia areata [4].

How can you treat bald spots

Losing body hair happens for a variety of reasons, but whether you're battling diffuse alopecia areata or think you're at risk of losing all the hair on your head, there are medical treatments available to help combat bald patches, save your remaining hair and help your hair grow.

Topical corticosteroids

The most common treatment of alopecia areata is topical corticosteroids, which is a first-line therapy due to its lack of side effects. These topical treatments are available in a range of forms, from solutions to shampoos to foams to corticosteroid creams.

A recent study found that corticosteroids had an 85% success rate of hair regrowth in people experiencing alopecia areata [5]. This makes it a safe treatment for your entire scalp or wherever you're experiencing hair loss.

Corticosteroid injection

Performed in a series of 3-5 sessions every 4-6 weeks, these steroid injections are performed by a doctor directly into the bald patch on your scalp, eyebrows or beard.

The reported treatment response is a 60% success rate, making it an often successful treatment option, but it can have minor side effects such as skin atrophy and pain at the injection site [5].

Clinical treatments

Tackling hair loss with a personalised treatment that is clinically proven and made for your particular hair loss experience can be life-changing. Enter Pilot's customised hair loss treatment.

Simply complete an online consultation and a practitioner will create a hair loss treatment plan based on your individual needs. From here, your treatment will be compounded in an Australian lab before being delivered discreetly to your home.

And, the results speak for themselves — 83% of users keep their hair with this treatment and 66% experience hair regrowth [6].

Men who treat hair loss in the early stages can prevent further balding and have a better chance of regrowing their hair, so be sure to jump on treatment as soon as possible.

Other supplements and treatment options

While the 3 treatments above are some of the most common to combat losing hair, there are numerous other options to address alopecia areata.

In particular, Pilot's Hair Growth Booster Kit is steeped in vitamin B7, otherwise known as biotin, which is known for its impact on hair follicles and the entire body.

A recent study found that biotin had a positive impact on stopping hair falls and preventing patchy hair loss in people with vitamin deficiencies [7], and paired with a microneedling Derma Roller to stimulate hair growth, this kit is tailor-made for anyone experiencing hair shedding.

Image credit: Getty Images

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