Scabs on Scalp: Causes, Prognosis, and Therapy

Scabs, sores, and bumps on your scalp can be painful, itchy, and irritating. Most scabs and sores on the scalp are not a cause for concern and clear up on their own or with help from over-the-counter (OTC) treatments.

While you might be tempted to pick at or scratch them to get relief, doing so can make them worse or lead to infection. In some cases, scabs on the scalp can also be a condition that requires medical attention and treatment. 

Here are some of the most common causes of scalp scabs, how they can be treated, and when you should see a doctor.

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Contact Dermatitis

Contact dermatitis is an itchy, red rash that is caused by direct contact with irritants or allergens. Scratching the rash can lead to open sores and scabs on the scalp. 

Many products, including fragrances, soaps, shampoos, cosmetics, and plants, contain ingredients or substances that can cause contact dermatitis.

Treatment

Home remedies can often relieve the painful, itchy rash that is caused by contact dermatitis. Here are a few that you can try.

  • Cool compresses: Cool compresses can help temporarily relieve the itch, sting, and burn that is caused by the rash. Place a cold, damp cloth over the rash for 10 to 15 minutes, several times a day.
  • Moisturizer: Lotions and creams can act as a barrier for dry, cracked skin and soothe any discomfort. Select a fragrance-free, hypoallergenic product to help prevent the rash from getting worse.
  • Oatmeal baths: A lukewarm oatmeal bath can help soothe a rash. Adding oatmeal to your bathwater can relieve itching and discomfort. Colloidal oatmeal bath additives are available over-the-counter.  

If home remedies do not help, your doctor might prescribe a treatment. Medications that can be used to treat contact dermatitis include: 

  • Antihistamines: These medications help reduce inflammation and swelling caused by the rash. 
  • Antibiotics: Open sores on the scalp from scratching can lead to bacterial infection, which might need to be treated with antibiotics.
  • Corticosteroids: These medications can be applied on the skin (topically) to soothe the rash or taken by mouth (orally) to reduce inflammation.

Psoriasis

Psoriasis is a long-term, chronic inflammatory skin condition that occurs most commonly on the elbows, knees, trunk, and scalp. It causes thick patches of gray or silver scabs on the skin that appear without scratching.

Scalp psoriasis may look like dandruff flakes, or appear as thick, crusty plaques covering the scalp.

Treatment

Psoriasis treatment depends on the severity of the condition. Mild cases of scalp psoriasis can be cleared up by using a medicated shampoo that eases itching and reduces skin overgrowth.

You can also use OTC medicated shampoos with salicylic acid (which helps remove excess skin) and coal tar (which relieves inflammation and slows the growth of skin cells). 

If you have a more severe case of psoriasis, or OTC treatments have not worked for you, your doctor may prescribe medications or another type of treatment.

Other ways to treat scalp psoriasis include:

  • Light therapy: The first-line treatment for moderate to severe scalp psoriasis, light therapy exposes the skin to controlled amounts of natural or artificial light. 
  • Oral or injected medications: Corticosteroids, methotrexate, and biologics can help slow the growth of skin cells, reduce inflammation, or suppress an overactive immune system. 
  • Topical solutions: Medicated shampoos, topical steroids, and tars slow skin growth and reduce inflammation and swelling. 

Lice

Head lice are wingless insects that live on the human scalp and feed on blood. If you have head lice, you may feel something moving on your scalp. Bites from lice can cause your scalp to itch.

Even though your head might be itchy, scratching can cause wounds and scabs on the scalp. Head lice do not carry bacterial disease, but scabs on the scalp from itching may lead to infection. 

Treatment

Head lice are highly contagious. If you have lice, or someone in your home does, it is important to treat the condition quickly.

There are several treatments for lice, including:

  • Over-the-counter (OTC) products: Shampoos containing pyrethrin or permethrin are the first-line treatment for head lice. Follow the directions on the label when using these products. If the OTC options do not work, your doctor may prescribe shampoos that have different ingredients.
  • Oral prescription medication: Medications, such as oral ivermectin, are prescribed for lice infestations that have not responded to OTC treatments. 
  • Topical prescription medications: Topical medications such as malathion can be applied directly to your hair and rubbed into the scalp. 

If you have lice, or someone in your home does, it’s also important that you wash all bedding, clothing, and furniture with hot water, and dry on high heat. Soak all hairbrushes and combs in hot water (130°F) to kill the lice and their eggs.

Dermatitis Herpetiformis

Dermatitis herpetiformis is a chronic skin condition that occurs in people with gluten sensitivity or celiac disease. It produces clusters of blisters and bumps on the skin and along the hairline that are intensely itchy.

Many people feel a burning sensation before the bumps appear. The red bumps and blisters form a scab and tend to heal within a week or two. Scratching the blisters and bumps can also cause scalp scabs. 

Treatment

Dermatitis herpetiformis is treated with a prescription antibiotic called dapsone, which provides almost immediate symptom relief. However, the medication does not cure the condition—it only relieves symptoms.

Since the condition is caused by gluten sensitivity, the best remedy is to follow a strictly gluten-free diet. Some people with dermatitis herpetiformis may need to continue medication while on a gluten-free diet until the skin clears up completely. 

Seborrheic Dermatitis

Seborrheic dermatitis is a common skin condition of the sebaceous regions of the scalp. It causes patches of greasy skin that are covered with itchy white or yellow crusty, powdery flakes. Scratching these spots can lead to scabs on the scalp. 

Some scientists believe the condition might be caused by an overgrowth of yeast from the genus Malassezia. This type of yeast is often found in high amounts on the skin of people with seborrheic dermatitis.

Seborrheic dermatitis is also called “cradle cap” when babies get it and “dandruff” when it occurs in adults.

Treatment

Home remedies may help control and eliminate seborrheic dermatitis, including OTC shampoos (e.g., Head & Shoulders, Selsun Blue, T/Gel) that contain ingredients that help treat the condition.

You can also apply mineral oil or olive oil to your scalp, let it sit for one hour, then comb or brush out your hair to reduce the dry, crusty patches.

If home remedies or OTC products do not help, your doctor may prescribe medicated shampoos or ointments that you apply directly to the scalp to reduce inflammation. If topical treatments do not work, your doctor may prescribe an antifungal medication that you take as a pill.

Eczema

Eczema usually appears on visible areas of skin, but it can also appear in less easy-to-see places, such as the top of your head. Scalp eczema causes itchy, dry, red, and inflamed skin and may also cause a burning sensation.

Though scalp eczema itself does not cause scab formation, scratching the itchy parts of your scalp can wound the skin, which in turn will lead to scabbing.

Treatment

There is no cure for scalp eczema, but treatments can help reduce the symptoms. You can try using a medicated, over-the-counter shampoo to reduce the itchiness and get rid of any flaky, scaly skin covering the scalp.

Look for shampoos that contain salicylic acid, coal tar, or zinc to help manage the condition. You may also try topical ointments, creams, or sprays that contain these ingredients. Apply them to the spots on your scalp that are particularly irritated and itchy.

If you have severe scalp eczema and OTC products are not helping, your doctor may prescribe products with stronger doses of the ingredients. They may also prescribe medications such as corticosteroids, ciclopirox, sodium sulfacetamide, or other drugs that suppress the immune system.

Your doctor might also suggest light therapy (phototherapy)—a procedure in which your scalp is carefully exposed to ultraviolet light. Alternatively, spending time in the sunlight may improve scalp eczema symptoms.

Shingles

Shingles is a painful skin rash that is caused by the varicella (herpes) zoster virus. The virus causes a painful rash with blisters that open and eventually scab. Along with the rash, shingles may also cause headaches, fever, chills, and an upset stomach.

The shingles rash is most commonly found on the face and body, but blisters can also form on the scalp, which may make it painful to brush or comb your hair.

Treatment

There is no cure for shingles, but medication can help reduce symptoms and shorten the duration of the outbreak.

Medications that are often prescribed for shingles include:

  • Antiviral medications (e.g., Valtrex, Zovirax)
  • Pain medication
  • Topical treatments  

Eosinophilic Folliculitis

Eosinophilic folliculitis is a skin and scalp disorder that causes recurring itchy, red, or skin-colored bumps and pustules (bumps containing pus) that eventually scab over. The scalp scabs can spread and may recur. 

The condition is not contagious and is most commonly diagnosed in people with late-stage human immunodeficiency virus (HIV).

Though the sores itch, it is best not to scratch them. Doing so can lead to scabbing and infection.

Treatment

The treatment for eosinophilic folliculitis varies depending on the severity of the condition and a person’s response to previous medications.

Possible treatments for the condition include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Dapsone (antibiotic) 
  • Topical and oral steroids 
  • Phototherapy (light therapy)

Neuropathic Itching

Some people get nerve-related itching on the scalp. With neuropathic itching, there is no rash. A person just experiences the feeling of needing to scratch, which can lead to scabs.

The cause of neuropathic itching is unclear, but it is thought to be related to cutaneous nerves. It can also be associated with metabolic, orthopedic, neurological, infectious, and autoimmune conditions.

Neuropathic itching can often be treated with systemic medications like gabapentin.

Complications

Scabs form on the skin and scalp as part of a healing process in which new skin grows over damaged skin.

Scabs are a sign of healing, and it’s important to leave them alone. When you pick at a scab, you may be exposing the delicate new skin underneath to infection. Picking at scabs may also cause scarring. 

Though it may be hard, try to avoid scratching and picking at scabs. They typically fall off and disappear on their own over the course of a few days to two weeks, depending on the size and cause of the scab. 

Treating Scabs

Scabs can be a sign of a skin condition or disease. While many causes can be managed at home, you need to know what is causing your scabs to ensure you are using the right treatment.

Follow all the recommendations from your doctor, including taking medications as prescribed to help the scabs heal and to reduce the risk of potential complications.

Home Remedies

Home remedies are not a substitution for medications or treatments that your doctor recommends, but they can be complementary therapy.

  • Aloe vera: You can cut a leaf of an aloe vera plant to extract the gel or purchase an over-the-counter aloe vera product. Apply it directly to the affected area on your scalp to soothe itching. Studies have shown that aloe vera gel might be an effective treatment for mild to moderate psoriasis.
  • Tea tree oil: This essential oil is available for purchase as an oil or as an ingredient in some shampoos. Studies have found that tea tree oil expedites (speeds up) wound healing, and might also be an effective way to treat seborrheic dermatitis and psoriasis.
  • Omega-3 supplements: These supplements are available over-the-counter in capsule or liquid form. Omega-3s might help reduce the inflammation that is caused by eczema and psoriasis, but more clinical research is needed to determine how effective they are as treatments for these conditions.

Frequently Asked Questions

Why do I have scabs on my scalp?

Scabs on the scalp are typically harmless and clear up on their own. Sometimes scalp scabs are a sign of a condition that requires treatment, such as dermatitis, head lice, or psoriasis. 

How do I get rid of scabs on my scalp?

Depending on the cause of scabs on the scalp, you might be able to treat them with medicated shampoos (which are available over-the-counter) or prescription medications such as antibiotics or steroids. These treatments can help relieve inflammation and redness, as well as prevent infection. 

How do you stop picking at scabs on your scalp?


Picking at a scalp scab can increase your risk of scarring or infection. Try to distract yourself by taking a walk, drawing, or engaging in an activity you enjoy—especially if it will keep your hands busy.

If you are picking at the scabs in your sleep, you might want to wear gloves at night to prevent yourself from scratching and give the scabs a chance to heal.

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