Got small bald circles with no warning? Centella creams might calm the area and kickstart new growth

Those small, round bald patches that suddenly appear on the scalp can be confusing. Many people, even without any history of hair problems, are surprised to find coin-sized spots with no hair.

The appearance of a "small bald circle" is an important sign to watch. It can indicate various conditions—from androgenetic alopecia, which is hormonal, to alopecia areata, which is autoimmune. Identifying these patches is the first step in understanding what’s happening to your scalp.

Alopecia areata, in particular, tends to show up without pain, itching, or any warning. While conventional treatments such as corticosteroids or immunotherapies are available, interest has grown in natural approaches that may help soothe the scalp and, in some cases, support regrowth. Among these, creams with Centella asiatica extract are gaining attention from both dermatologists and patients.

Centella asiatica: an ancient plant with new uses

Centella asiatica is a plant native to Asia that has been used for centuries in Traditional Chinese Medicine and Ayurveda for its wound-healing and anti-inflammatory properties. In modern dermatology, it’s been explored for its ability to improve skin texture, reduce inflammation, and support healing. More recently, its use in scalp health has come under investigation, especially for conditions like alopecia areata, due to its potential to reduce local inflammation and improve microcirculation.

Alopecia areata is an autoimmune condition where the body’s immune system mistakenly attacks hair follicles, disrupting the natural hair growth cycle. Although the exact cause is unclear, it has been linked to genetic predispositions, stress, and other autoimmune diseases such as hypothyroidism or type 1 diabetes. The hallmark sign of this condition is its sudden onset and the round shape of the bald patches, which may expand or, in some cases, resolve completely without treatment.

What happens to the follicles when bald circles appear?

When these bald patches form, hair follicles don’t completely disappear. Instead, they enter a deep resting phase due to the immune system’s attack. The follicle bulb isn't necessarily destroyed but becomes severely disrupted. In some cases, if inflammation subsides, the follicles can reactivate and begin producing hair again. However, this doesn't happen in every case, and medical treatment may be necessary.

Centella creams: just a trend or scientifically supported?

While many Centella-based products are advertised as miracle solutions, it’s important to review what science actually says about their effectiveness. A study published in 2005 in the Journal of Ethnopharmacology explored the effects of Centella extract on skin cell proliferation and collagen production. Researchers found increased fibroblast activity (cells that repair tissue), which could aid tissue regeneration in inflamed areas.

More directly related to hair, a 2020 study in Biomedicine & Pharmacotherapy examined a topical Centella formulation in mice with induced alopecia. The extract showed a significant improvement in hair density and regrowth compared to the control group. While this study wasn’t conducted in humans, it opens the door to the plant’s therapeutic potential in autoimmune scalp conditions.

What’s the difference between minoxidil drops and Centella cream?

Minoxidil is a vasodilator that directly stimulates hair follicles by prolonging their growth phase (anagen) and increasing follicle size. Its efficacy is well-established, and it’s FDA-approved to treat various types of alopecia. Centella, on the other hand, doesn’t act directly on the follicle or hair cycle. Instead,

Its effects are more indirect: it reduces inflammation around the follicle and improves local blood circulation.

Centella-based creams may help soothe the affected area and create a more favorable environment for regrowth, but their impact is neither as immediate nor as potent as pharmaceutical treatments like minoxidil.

Examples of Centella creams on the market

On platforms like Amazon, you’ll find a wide range of Centella-based creams marketed for scalp and skin care. Some notable products include:

Madecassol Cream (Bayer): marketed primarily as a healing cream, widely used in South Korea and other countries to soothe irritation and promote skin regeneration.

Cicapair by Dr. Jart: sold as a calming facial treatment, though many users report applying it to sensitive scalp areas with some benefit.

Skin1004 Madagascar Centella Soothing Cream: formulated with pure extract, it targets inflammation and is promoted for sensitive or redness-prone skin.

All these products emphasize their anti-inflammatory, calming, and regenerative properties, appealing to consumers seeking gentle, natural solutions for skin and scalp care.

User Experiences

In discussions on Tressless, a few users have shared insights that touch directly on the question of using Centella asiatica (often found in skin-calming creams) for sudden-onset bald spots, such as alopecia areata or post-surgical scalp trauma. One user posted about experiencing large bald areas in the donor region after a hair transplant and described using a combination of La Roche-Posay’s B5 Centella cream and thermal water to soothe the irritated scalp. They mentioned that it helped reduce inflammation, although they didn't report substantial regrowth directly from the Centella itself. The post also referenced concerns about scalp necrosis and inflammation, which are serious conditions that sometimes occur after transplants or due to infection. Other users responded recommending anti-inflammatory and healing-focused topicals, including those containing Centella, particularly for scalp recovery. However, no user explicitly confirmed new hair growth attributed to Centella alone.

Another discussion involved exosomes, including those derived from Centella asiatica. A few users were curious about their role in stimulating hair growth, with some skepticism. One user compared them to conventional treatments like finasteride, noting that while Centella-based exosomes might be promising, there was not yet strong evidence or visible results from the community to support their effectiveness as a standalone hair growth stimulant.

Overall, while Centella-based products were viewed positively for reducing scalp irritation and supporting recovery, user feedback does not provide strong support for the claim that these creams alone can trigger new hair growth in bald patches. The general sentiment is that they may help calm inflammation and contribute to a healing environment, especially post-procedure or during inflammatory episodes, but more powerful treatments are typically necessary for regrowth.

So, back to the original question: can Centella creams calm the area affected by alopecia areata and possibly stimulate hair regrowth? The answer is a cautious yes—especially in mild cases.

These creams may help reduce inflammation and improve local circulation, creating better conditions for regrowth.

However, results will vary depending on the severity of the condition, consistency of use, and individual response. The difference between Centella and more established treatments like minoxidil lies in their action and strength. While Centella may serve as a low-risk complementary aid, minoxidil has a more direct and clinically proven effect on hair follicles.

References

Kimura, Y., Sumiyoshi, M., & Baba, K. (2005). Antiinflammatory effects of Centella asiatica and its triterpenes in chronic UVB-exposed hairless mice. Journal of Ethnopharmacology, 96(1–2), 245–249. https://doi.org/10.1016/j.jep.2004.09.032

Kim, J. H., Hwang, J. H., Kim, J. Y., & Lee, H. J. (2020). Centella asiatica extract promotes hair growth in mice with alopecia. Biomedicine & Pharmacotherapy, 128, 110294. https://doi.org/10.1016/j.biopha.2020.110294

Tressless. (2023, December 21). Huge holes on donor area of scalp is this even normal? Reddit. https://reddit.com/r/tressless/comments/18nvl4b/huge_holes_on_donor_area_of_scalp_is_this_even/

Tressless. (2025, January 22). Exosomes 2 months before and after. Reddit. https://reddit.com/r/tressless/comments/1i7bgzj/exosomes_2_months_before_and_after/