Several things can cause bald spots or patches in the beard. Alopecia, ringworm, and chemotherapy are among the most common causes.

This article will explore these causes in more detail, explain how to treat beard hair loss, and discuss when a person should speak to a doctor.

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Causes of bald spots or patches in the beard may include alopecia, ringworm, and chemotherapy.

A number of things can lead to bald spots developing in a person’s beard. Some of the most common causes include:

Alopecia

Alopecia areata is an autoimmune condition that causes hair loss. It is not contagious. Most people develop the condition when they are children.

The condition occurs when the body’s natural defense, the immune system, attacks the hair follicles and causes the hair to fall out.

It tends to cause round or oval bald patches on the scalp, but it can affect any part of the body. When it affects the beard, doctors call it “alopecia barbae.”

Around 2 in every 100 people will develop alopecia at some point in their lifetime. Around 6.8 million people in the United States and 147 million people worldwide experience alopecia.

Ringworm

Fungi cause ringworm, which is a common skin infection. It can affect any part of the body. When it affects the beard, it is known as “tinea barbae.”

Symptoms tend to develop around 4–14 days after the person has encountered the fungus. Some common sources of infection include:

  • A person with ringworm: Anyone with a ringworm infection should not share clothes, towels, hairbrushes, or any other personal items.
  • An animal with ringworm: Animals such as cats, dogs, cows, goats, pigs, and horses can spread ringworm to humans.
  • The environment: The fungi that cause ringworm thrive in damp areas such as locker rooms and public showers.

Ringworm of the beard is not common. It most often occurs in warm and humid climates.

Tinea barbae is most common in males. However, it may affect females with dark, coarse hair on their face and neck.

Chemotherapy

Chemotherapy is one of the most common cancer treatments. It frequently leads to hair loss, which doctors call “chemotherapy-induced alopecia” (CIA). It can affect any part of the body, including the scalp, eyebrows, eyelashes, and beard.

The extent of the hair loss depends on:

  • the drug or combination of drugs that the healthcare professionals have prescribed
  • the dosage
  • the way the person’s body reacts to the drug or drugs

Not everyone who undergoes chemotherapy will lose their hair, but some will. Some people experience mild shedding that is hardly noticeable, while others can lose their hair or beard entirely.

Bald patches in the beard can come on suddenly or over a period of time. The bald patch may also vary in size. The cause of the bald patch may also cause additional symptoms to occur.

The sections below will discuss some other symptoms that each condition may cause.

Alopecia

Some people with alopecia may also develop indents on the fingernails. There are not usually any other symptoms, though some people say that the skin becomes itchy or red before the hair falls out.

Ringworm

The symptoms of a ringworm infection include:

  • a circular rash that looks like rings
  • itchy skin
  • red, scaly, or cracked skin
  • hair loss

The symptoms of tinae barbae also include scaly, itchy, red spots, which can develop on the cheeks, chin, and top of the neck. These spots might be crusty or filled with pus.

Chemotherapy

There are not usually any additional symptoms of CIA. It is not possible to know if chemotherapy will cause hair loss or thinning before the treatment begins.

A healthcare professional will usually be able to diagnose the cause of a bald patch in the beard with a quick examination.

The sections below will discuss the possible diagnosis process for each condition.

Alopecia

A doctor or dermatologist can usually diagnose alopecia barbae by examining a person’s symptoms.

For example, they may look at the degree of hair loss and examine some samples of hair under a microscope. This will usually be quick and straightforward.

They may also perform a skin biopsy or blood test to rule out an infection or underlying medical condition, such as other autoimmune conditions.

Ringworm

A doctor will diagnose ringworm by looking at the skin. They may also scrape off a sample of skin to study under a microscope.

Chemotherapy

Hair loss is a common side effect of chemotherapy. Although it does not affect everyone who undergoes this treatment, in those it does affect, the hair usually begins to fall out around 1–3 weeks after treatment begins.

After diagnosing the cause of a bald patch in the beard, a doctor may be able to suggest medications to treat the hair loss.

In some cases, people may wish to try these medications or home remedies. In other situations, they may wish to prepare for the hair loss by shaving their beard off.

The sections below will discuss the treatment options for each condition.

Alopecia

A doctor may prescribe steroid creams to people with mild cases of alopecia. In more severe cases, they may recommend steroid injections or steroid tablets.

Ringworm

People can use over-the-counter antifungal creams, powders, or ointments to treat mild-to-moderate cases of ringworm. Products such as clotrimazole, miconazole, and terbinafine can usually clear up the infection within 2–4 weeks.

A doctor may prescribe a stronger antifungal medication if required. Such products are usually in the form of tablets. They can take around 1–3 months to clear the infection.

Chemotherapy

Some people decide to shave their beard off before starting chemotherapy treatment. This can be less traumatic than watching it fall out.

There is not much evidence to support the effectiveness of home remedies to treat hair loss in the beard area. However, none of these remedies are likely to cause harm, so they may be worth a try.

Some home remedies for hair loss include gently rubbing any of the following into the beard area:

  • garlic juice
  • onion juice
  • cooled green tea
  • aloe vera
  • castor, coconut, or almond oil
  • lavender, rosemary, or geranium oil
  • fish oil

Some people may take zinc or biotin tablets, as well as hair growth supplements. Others may turn to alternative treatments, such as acupuncture or aromatherapy.

Learn more about home remedies for hair growth here.

Learn more about home remedies for ringworm here.

The time required for the hair to recover will vary from person to person. It will also depend on the cause of the hair loss and the treatment received.

For example:

Alopecia

In general, people who have one or two bald patches make a full recovery. The hair tends to grow back within 1 year, even without treatment.

In around 30% of people with alopecia, however, the hair loss is more extensive, and the bald patches might come back. Many people with extensive alopecia find that none of the available treatments work for them.

Ringworm

As mentioned above, most treatment options can usually clear the infection within 2–4 weeks. However, in some cases, it may take up to 1–3 months.

Chemotherapy

Usually, a person’s hair will begin growing again a few months after chemotherapy has ended. When it does, the hair may be thinner and a different color and texture. This difference is usually temporary, however.

In most cases, a person’s hair will fully recover within 6–12 months.

If a person feels that the bald patch is affecting their quality of life, they may wish to consider seeing a doctor. They may be able to assess the severity of the symptoms, determine the potential cause, and suggest some appropriate treatment options.

The sections below will look at when to see a doctor for each condition.

Alopecia

Anyone who suspects that they have alopecia should speak to a doctor. A number of treatments are available, but they are not all effective for everyone.

Ringworm

If the infection has not disappeared within 2–4 weeks, a person should seek medical help.

Chemotherapy

Certain chemotherapy drugs may cause the hair to grow back at a slower rate. In some people, they may cause permanent hair loss. However, this is usually rare.

If worried, a person can speak to their doctor about this.

A number of different conditions can cause bald patches in the beard. These include alopecia, ringworm infections, and chemotherapy treatment.

In most cases, beard hair loss is not permanent. Most people with alopecia will make a full recovery, though the hair loss may come back with time.

A ringworm infection is treatable using over-the-counter products, though a person may need to see a doctor if the infection does not clear within a few weeks.

CIA is usually temporary. The hair tends to grow back after the treatment has finished, though it might be different in color and texture for up to a year.