Temporal triangular alopecia (also known as congenital triangular alopecia) is an uncommon hair loss condition which affects 0.11% of the worldwide population [1]. Its main symptom is a bald spot on your temple or frontal area. Usually detected in childhood, this condition remains unchanged throughout life [2]. Since the hair loss is often mild, researchers believe most cases go undiagnosed.
However, if your temporal triangular alopecia bothers you, it is easily fixable with a low volume hair transplant. Find out all about this condition, including:
Temporal triangular alopecia is also known as congenital triangular alopecia. It is a non-scarring, non-inflammatory type of hair loss which usually manifests around the temples or the frontal area of your scalp. In this condition, the hair follicles in the affected area are miniaturised, so they either don’t produce any hair at all or only produce very small (vellus) shafts.
Research shows that 33.6% of temporal triangular alopecia cases are discovered at birth and 55.8% more between the ages 2-9. Only 3.8% are first noticed in adulthood [3][1].
In most cases (79%), this condition only affects one side of the head. However, some people experience symmetric bald spots on both sides (18.5%). And while congenital triangular alopecia normally affects your temples and frontal area, it can very rarely affect the back of your head instead[1].
The causes of congenital triangular alopecia are currently unclear. It is often inherited from a family member, suggesting that it is likely genetic, though no specific genes involved in this process have been uncovered [3].
Some researchers believe triangular alopecia may be caused by a dermatological defect [1]. This may also have a genetic component, but more research is necessary to determine the mechanism of this condition.
The main (and often the only) symptom of congenital triangular alopecia is a triangular, oval or lancet-shaped bald spot in the frontal or temporal area of the scalp. These bald spots are often 2-4 cm in length [4] and reveal no hair growth or only miniaturised hair. In rare cases, the hair isn’t fully missing, but it is smaller and darker-coloured than the surrounding area [1]. While this type of alopecia is usually contained to one side of the head, in almost 20% of patients, it can be found on both sides [1].
A defining feature of temporal triangular alopecia is that it does not change size and shape over time. Additionally, it doesn’t spread to other areas of the scalp or produce inflammation, redness, pain or discomfort. In rare cases, patients can experience tingling in the affected area [5].
This type of hair loss may be hereditary, as medical history often shows it runs in families [1]. This means that if one of your parents (or another close biological relative) is experiencing this condition, you likely have a greater chance of developing it as well.
There don’t seem to be any significant gender differences when it comes to congenital triangular alopecia, so men are as likely to experience it as women.
White patients may be somewhat more likely to develop congenital triangular alopecia, but the condition has also been reported by Asian and Black patients [1].
Congenital triangular alopecia sometimes develops alongside other conditions, such as Down’s syndrome, bone and tooth abnormalities or congenital heart disease [5]. However, these occurrences are rare. If you have temporal triangular alopecia, it doesn’t necessarily mean you also have another condition [3].
Congenital triangular alopecia can often be diagnosed visually with a simple dermoscopy, alongside an examination of your medical history and symptoms [1][5][6]. A scalp biopsy is only performed in rare and complex cases. This can rule out other similar conditions when the clinical examination isn’t conclusive [1].
During the clinical examination, your trichologist will check for a patch of miniaturised (or absent) hair without other symptoms, such as inflammation, lesions, broken hair shafts or coloured dots on the scalp.
Congenital triangular alopecia (CTA) can be mistaken for several other hair loss conditions. Here are some of the most similar and how you can tell them apart from temporal triangular alopecia [1]:
Alopecia areata
Androgenetic alopecia
Traction alopecia
Trichotillomania
Patient with congenital triangular alopecia before and after 500-graft FUE hair transplant
In most cases, temporal triangular alopecia is too mild to make those who experience it seek treatment, which is why it is also often underdiagnosed. However, treatment options exist.
The most effective (and the only long-lasting) way to treat temporal triangular alopecia is a permanent hair transplant. This simple, outpatient surgery involves taking some healthy hair follicles from the back of your head and inserting them into the bald spot on your temple area. Since this only requires a few hundred hair grafts (normally around 250-500), hair transplant costs should be lower than average and recovery should be relatively easy.
Alternatively, while more research is needed to study the effect of different hair growth medications on congenital triangular alopecia, one treatment seems promising. A few case studies reported an improvement in the number of normal-sized terminal hairs in the affected area after treatment with topical Minoxidil [2][7]. However, the effects of Minoxidil only last as long as you take the medication.
Yes, temporal triangular alopecia is a permanent condition. It doesn’t change throughout your lifetime and there are no recorded cases of spontaneous remission. The only way to curb this type of hair loss is by treating it with Minoxidil or getting a hair transplant.
However, the good news is that in most cases, the hair loss produced by this condition is mild and easy to mask. Most people feel no need to get treatment for it.
There are several good ways to camouflage your congenital triangular alopecia. Here are some of the best.
The hair surrounding your bald spot is your most effective camouflaging tool. Choosing a slightly longer, side-swept hairstyle can be enough to render your bald patch invisible.
Since congenital triangular alopecia usually causes temporal or frontal balding, you might also find some inspiration among these female hairstyles for a receding hairline (or, respectively, these male hairstyles for receding hairlines).
Using a coloured hair thickening spray on your bald spot can reduce the colour contrast between your hair and skin. Moreover, the microfibres in the spray cling to vellus hairs on your problem patch, creating the illusion of hair coverage. This will make your affected area less visible, especially from a distance. It works best for people wearing short hairstyles.
A cap, hat, headband, head scarf or beanie can fully hide your bald spot. For minor hair loss, an accessory such as a larger decorative hair clip can help cover the affected area.
If your hair loss is more significant, you may be able to order a custom-made hairpiece to cover the bald spot. Natural hair options can look quite lifelike, and modern attachment systems can be semi-permanent.
Scalp micropigmentation (SMP) is frequently used to mask hair thinning on your scalp. A type of hair tattoo, in SMP the technician injects small dots of pigment into your bald spot, replicating natural hair growth patterns. This reduces the colour contrast between your scalp and hair, making your bald area less visible. It works best if you wear a short haircut, such as a buzzcut or a pixie cut.
However, to avoid SMP regrets, note that this procedure does not work well for people with lighter hair shades, such as blondes or redheads, as there are no matching pigment options.
If you are experiencing temporal triangular alopecia and have grown tired of hiding your bald patch, we are here to help. Book a consultation with one of our top trichologists at your most convenient clinic location. They will assess your hair loss and work with you to determine the most appropriate and effective treatment.
If you are interested in getting a natural-looking hair transplant, our experienced hair doctors will assess whether you can benefit from this procedure. The Wimpole Clinic is one of the leading hair transplant facilities in the UK, with a 50-year legacy of hair restoration excellence. See our results for yourself in our before and after hair transplant photo gallery.
If you would like to discover more about congenital triangular alopecia, here are the answers to some frequently asked questions.
Yes, despite the name of this condition, your bald spot doesn’t have to be triangular, it can also be oval, round or lancet-shaped [1]. It takes its name from the most common form of presentation, which is triangular [6].
There are currently no recorded cases of temporal triangular alopecia on the crown. It can rarely occur at the back of your head, but if you see a bald spot on your crown, the best thing to do is see a trichologist. They can help rule out other types of alopecia.
Since the cause of congenital triangular alopecia is still unclear, it is hard to say if anything could prevent it. However, since most of the evidence appears to point towards a genetic nature, this condition is likely not preventable (but more research is needed to prove this).
At this time, there is no evidence that the male hormone dihydrotestosterone (DHT) (which causes hair miniaturisation in androgenetic alopecia) is a factor in congenital triangular alopecia. Since Finasteride works by lowering the DHT levels in your blood, there is no proof it can help curb or reverse this condition.
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