What could be the cause of a bald patch in the middle of the head?

From your description, the cause of his bald patch is most likely due to alopecia areata.

I agree with Dr Joshua Chong who has explained in detail the autoimmune cause of this condition, and how it can be triggered by stress sometimes.

We do treat alopecia areata regularly in our Dermatology clinic and good improvement can usually be seen with monthly steroid injections into the bald area after 2-4 treatments.

Occasionally, we also prescribe topical treatments to apply to the area in between injections. If he only has one bald patch, the likelihood of good improvement is very high. There remains a chance that the condition may recur in the future.

Warmest regards

Dr Stephanie Ho, Dermatologist

What you are describing sounds like a hair loss condition called Alopecia Areata. In this condition there can be sudden and complete loss of hair in one or several well defined patches. It affects not only the scalp, but can also affect facial hair, eyebrows and other parts of the body.

Alopecia areata is an auto-immune condition - it is caused by immune proteins called 'antibodies' that attach normal hair follicles.

There are several conditions that can be related to alopecia areata, or AA, for short - including other autoimmune diseases like lupus, thyroid diseases. Emotional stress can also be a trigger for AA. AA can also be a recurring condition.

The well-accepted treatment is to inject a medium-strength steroid to control the auto-immune effect in that area of scalp. This can be repeated monthly until hair grows back.

However, I would advise that a doctor familiar with hair loss assess your boyfriend to take a thorough history and examine his scalp to confirm the diagnosis of AA, as well as to look for other affected areas that might not have been seen.

There are other treatments that can be adjunctive to steroid injections but your hair restoration doctor would be able to advise you with that during a detailed consultation.

I hope that helps.

Regards,

Dr Joshua Chong