Scalp Scabs: Causes and How to Treat Them

Understanding Scalp Problems
Scalp scabs can be itchy, unsightly, and frustrating. Scratching generally makes them worse and increases your chances of infection. In many cases, scalp scabs clear up on their own or with over-the-counter treatments. Most of the time, they don’t indicate serious illness. If you can’t identify the cause of scalp scabs, or if they’re spreading or appear infected, see your doctor.

Read about some of the most common causes of scalp issues, including dandruff, lice, and more.

Contact Dermatitis
Contact dermatitis is an allergic reaction to something you’ve touched. Health and beauty products like shampoo, hair dye, or jewelry can cause an allergic reaction. Certain materials, like latex, can also lead to a reaction. So can outdoor foliage, such as poison ivy or poison oak. You may have a bad reaction if toxic substances like battery acid or bleach touch your scalp.

An allergic reaction can cause your scalp to develop dry patches that itch or burn. If you scratch, you can cause bleeding and scabbing. Your scalp should clear up on its own, but see your doctor if the area appears infected, is getting more painful, or is spreading. Be very careful to avoid coming into contact with the irritant again. Allergic reactions can grow stronger with multiple exposures.

Seborrheic Dermatitis (Dandruff)
Seborrheic dermatitis is a skin condition that can affect your scalp. Symptoms include itching, flaking, and scabbing. Crusty patches of skin are usually white or yellow and can attach to the hair shaft.

The cause is not clear, but it has nothing to do with cleanliness. You can shampoo your hair every day and still have dandruff. Even newborn babies can have it (cradle cap). It’s not contagious, and it isn’t usually a sign of poor health. Unfortunately, it can take a long time to get dandruff under control. In some cases, it may become a lifelong problem that comes and goes.

You can buy over-the-counter medicated shampoos and topical ointments designed to treat dandruff. If that doesn’t help, there are some prescription medications you can try. Some of these drugs can have side effects, so be sure to follow package directions carefully. Report any problems to your doctor or pharmacist.

Scalp Psoriasis
Psoriasis is a skin condition that can affect various parts of your body. It can cause thick, silver-gray scabs all over the scalp. Mild cases can often be treated with medicated shampoo designed to treat the scalp and ease itching. If that doesn’t help, or your condition worsens, see your doctor. Severe cases may need topical or injectable steroids. If scalp scabs are accompanied by swollen lymph nodes, antimicrobial treatment may be necessary.

Seborrhoeic Eczema

With seborrhoeic eczema, your scalp becomes irritated, red, and scaly. Thick scabs can become itchy and very uncomfortable. The inflammation of seborrhoeic eczema can cause it to spread to your face, neck, and behind the ears. In severe cases, it can also spread to the rest of your body. The cause isn’t known. Eczema can be treated with medicated shampoos, which help to loosen scales. Prescription strength topical ointment may also be helpful.


Lichen Planus (Lichen Planopilaris)

Lichen planus is an ailment that causes red or purple bumps on the skin. When it affects the scalp, it’s called lichen planopilaris. It can lead to permanent scarring and hair loss (alopecia).

Anyone can get lichen planus, but it’s more likely to strike in middle age. It can sometimes be diagnosed by its appearance. A skin biopsy can confirm the diagnosis. Most of the time, there’s no known cause. It sometimes clears up on its own, but it can persist for years.

Treatment usually involves topical corticosteroid creams or oral steroids. In some cases, injectable steroids may be more helpful. If left untreated, lichen planopilaris can lead to hair loss, which may be permanent. Antihistamines can help with the itching.


Ringworm of the Scalp

Ringworm is a fungal infection involving your skin, hair shafts, and scalp. Symptoms include itching and scaly patches. Ringworm is most likely to involve children and is quite contagious. Treatment may include oral antifungal medication and medicated shampoos. Untreated, ringworm can lead to extreme inflammation, scarring, and hair loss that may be permanent.


Head Lice

Nobody likes the idea of head lice. As unnerving as they are, the good news is that they don’t carry disease or cause any major health concerns. If you have head lice, you’ll probably feel something moving on your scalp, as well as itching. If you scratch too much, you’ll end up with scabs on your scalp, which can lead to infection.

If someone in your household has head lice, everyone who has been in close physical contact should be checked. Head lice can be treated with specifically designed, over-the-counter medications.

Another bit of good news is that head lice don’t live long once they fall off or are removed. They generally survive less than two days when they can’t feed.

Make sure to wash any bedding, clothing, and furniture that the infested person used during the two days before treatment. Use hot water for laundry and dry in high heat. Other items can be dry-cleaned. For items you can’t wash, closing them up in a plastic bag for two weeks will take care of adult lice and their offspring. The U.S. Centers for Disease Control and Prevention (CDC) suggests soaking hairbrushes and combs in 130 F water for 5 to 10 minutes.


Shingles

Shingles is caused by the same virus that causes chicken pox. After you have chicken pox, the virus remains dormant in your body. If activated, you get shingles. It mainly affects the skin, but scabs can form on the scalp as well. The shingles rash looks like small blisters that turn yellow and form a crust lasting up to two weeks. A shingles rash can be quite painful. It may also cause headache or facial weakness. Symptoms can continue for months. Treatment may involve antiviral medication, pain medication, and topical ointments.

Eosinophilic Folliculitis

Eosinophilic folliculitis is a skin and scalp condition that tends to affect people who have HIV/AIDS. It causes sores that itch, become inflamed, and fill with pus. When the sores heal, they leave a patch of darker skin. This type of scalp scab can spread and recur. There are various medicated shampoos, creams, and oral medications that may help control infection and ease symptoms. If you have HIV/AIDS and develop skin or scalp scabs, see your doctor.


Talk to a Doctor

With such a range of causes for scalp scabs and itchiness, it’s important to understand the source of your scalp problem as soon as possible. If you have questions about your scalp issues or want to start treatment, talk to your doctor.