Causes of Scalp Scabs and How to Treat Them

Scabs, sores, and bumps on your scalp can be itchy and irritating. They're sometimes even painful.

Most scalp scabs and sores aren't a cause for concern. They may clear up on their own or with over-the-counter (OTC) treatments.

It's tempting to scratch and pick at scabs. Don't—it can make them worse or lead to infection. In some cases, scalp scabs come from a condition that needs medical attention. 

This article looks at common causes of scalp scabs, how they're treated, and when you should see a healthcare provider.

Close up of a the back of the head of a person with a skin condition of the scalp.

logolis/Getty Images

Contact Dermatitis

Contact dermatitis is an itchy, red rash. It's caused by direct contact with irritants or allergens.

The rash can be anywhere on your body. That includes the scalp. Scratching it can lead to open sores and scabs. 

Many products contain fragrances and other ingredients that can cause contact dermatitis. That includes:

  • Soaps
  • Shampoos
  • Cosmetics
  • Hairstyling products
  • Hair dyes

Treatment

Home remedies may relieve a contact dermatitis rash. Common ones are:

  • Cool compresses: Temporarily relieve the itch, sting, and burn. Place a cold, damp cloth over the rash for 10 to 15 minutes, several times a day.
  • Moisturizer: Act as a barrier for dry, cracked skin and soothe discomfort. Choose fragrance-free, hypoallergenic products.
  • Oatmeal baths: Can relieve itching and discomfort. OTC colloidal oatmeal bath additives are available.  

If home remedies don't help, your doctor may prescribe:

  • Antihistamines (allergy pills): Help reduce inflammation and swelling. 
  • Corticosteroids: Topical forms (applied to the skin) soothe a rash. Severe cases may require oral (taken by mouth) or injected forms.
  • Antibiotics: Needed if scratching breaks the skin and leads to a bacterial infection.

Recap

Contact dermatitis is an itchy rash caused by an allergy or irritant. It's treated with cool compresses, oatmeal baths, antihistamines, and corticosteroids.

Psoriasis

Psoriasis is a chronic inflammatory skin condition. It's most often on the elbows, knees, trunk, and scalp.

Psoriasis is an autoimmune disease. That means you're being attacked by your own immune system.

In psoriasis, this makes skin cells reproduce too quickly. Then they "pile up." That causes thick patches of gray or silver scabs on the skin.

On the scalp, it may look like dandruff. It can also cause thick, crusty plaques.

Treatment

Psoriasis treatment depends on the severity. For mild cases, a medicated shampoo can ease itching and reduce skin overgrowth.

OTC medicated shampoos with salicylic acid help remove excess skin. Those containing coal tar can relieve inflammation and slow skin-cell growth.

For more severe cases, or if OTC treatments don't work, your healthcare provider may prescribe medications or other treatments.

Other ways to treat scalp psoriasis include:

  • Light therapy: First-line treatment for moderate to severe scalp psoriasis. It slows growth by exposing the skin to controlled amounts UVB light.
  • Oral or injected medications: Corticosteroids, methotrexate, and biologics can help slow skin-cell growth, reduce inflammation, or suppress an overactive immune system. 
  • Topical solutions: Medicated shampoos, topical steroids, and tars slow skin growth and reduce inflammation and swelling. 

Recap

Psoriasis is a chronic condition. It causes silvery scales or plaques. Medicated shampoo, light therapy, topical products, and medications that suppress immune activity are used to treat it.

Head Lice

Head lice are wingless insects that live on your scalp. They feed on blood.

You may feel them moving around on your scalp. And their bites can itch.

Scratching can cause wounds and scabs on your scalp. Head lice don't carry disease, but scabs can get infected. 

Treatment

Head lice are highly contagious. Prompt treatment is important to keep them from spreading.

Treatments for lice include:

  • OTC products: Shampoos containing pyrethrin or permethrin. If they don't work, your healthcare provider may prescribe shampoos with different ingredients.
  • Oral prescription medication: Medications like oral ivermectin are prescribed for lice infestations that don't respond to OTC treatments. 
  • Topical prescription medications: Malathion and other topical drugs are rubbed into the scalp. 

Also, it's important to:

  • Wash all bedding, clothing, and furniture with hot water.
  • Dry on high heat.
  • Soak all hairbrushes and combs in hot water (130°F).

That should kill the lice and their eggs.

Recap

Head lice cause an itchy scalp by moving around on it and biting you. They're highly contagious. Along with medicated shampoos and possibly oral medication, you should wash all bedding, clothing, brushes, and combs.

Dermatitis Herpetiformis

Dermatitis herpetiformis is a chronic skin condition. It occurs in people with gluten sensitivity or celiac disease.

Intensely itchy clusters of blisters and red bumps appear on the skin and along the hairline. The first symptom may be a burning sensation.

Then it scabs over and tends to heal within a week or two. Scratching it can also cause scalp scabs. 

Treatment

Dermatitis herpetiformis is treated with a prescription antibiotic called dapsone. The drug provides almost immediate relief. However, it doesn't cure it—it only relieves symptoms.

The best remedy is to follow a strictly gluten-free diet. (That'll help with many other symptoms, too.) Even so, you may need to keep taking medication for a while to clear it up completely. 

Recap

Dermatitis herpetiformis is a symptom of gluten sensitivity or celiac disease. You may feel burning and then develop bumps and blisters. It's treated with dapsone (an antibiotic). A gluten-free diet can clear it up and prevent it.

Seborrheic Dermatitis

Seborrheic dermatitis is a common skin condition. It affects the sebaceous (oily) regions of the scalp.

It causes patches of greasy skin covered with itchy, crusty, powdery flakes. The flakes may be white or yellow. Scratching these spots can lead to scabs. 

The condition may be caused by an overgrowth of Malassezia yeast. High amounts of Malassezia are often found on the skin of people with seborrheic dermatitis.

Seborrheic dermatitis is also called "cradle cap" in babies and "dandruff" in adults.

Treatment

Home remedies may help control and eliminate seborrheic dermatitis. They include OTC dandruff shampoos such as:

  • Head & Shoulders
  • Selsun Blue
  • T/Gel

You can also use mineral oil or olive oil on your scalp. Let it sit for one hour, then brush out your hair. That may help with dry, crusty patches.

If none of that works, your healthcare provider may prescribe medicated shampoos or ointments that reduce scalp inflammation.

If topical treatments don't work, you may need an oral antifungal medication.

Recap

Seborrheic dermatitis (cradle cap, dandruff) causes greasy patches and flaky skin. It may be caused by yeast. It's treated with dandruff shampoo, ointments, and, sometimes, antifungal medication.

Eczema

Eczema usually appears on visible areas of skin. But sometimes it strikes less easy-to-see places like the top of your head.

Scalp eczema causes itchy, dry, red, and inflamed skin. You may also feel a burning sensation.

Scalp eczema itself doesn't cause scabs. But scratching it can.

Treatment

There's no cure for scalp eczema. But treatments can help reduce symptoms. OTC shampoos may reduce itchiness and get rid of flaky, scaly skin.

Look for shampoos, ointments, creams, and sprays containing:

  • Salicylic acid
  • Coal tar
  • Zinc

Apply to itchy and irritated spots on your scalp.

If it's severe and OTC products don't help, your provider may prescribe something stronger. Other options are:

Sunlight or light therapy (phototherapy) may help, too.

Recap

Eczema causes red, itchy skin. It's treated with OTC shampoos and other topical products. Severe cases may require prescription treatments.

Shingles

Shingles is a painful skin rash caused by the varicella-zoster virus. That's the virus that causes chickenpox.

It causes a painful rash with blisters that open and scab over. Shingles may also cause:

  • Headaches
  • Fever
  • Chills
  • Upset stomach

The shingles rash is most often on the face and body. But blisters can also form on the scalp. That can make it painful to brush your hair.

Treatment

There's no cure for shingles. Medication can reduce symptoms and make the outbreak shorter.

Drugs prescribed for shingles include:

Recap

Shingles is a painful rash caused by the chicken pox virus. It's treated with antivirals, pain relievers, and topical products.

Eosinophilic Folliculitis

Eosinophilic folliculitis is a skin and scalp disorder. It causes recurring itchy, red, or skin-colored bumps and pustules (bumps containing pus). They eventually scab over.

The scalp scabs can spread and may recur. The condition isn't contagious. It's mostly found in people with late-stage HIV/AIDS.

Scratching the bumps can lead to scabbing and infection.

Treatment

The treatment for eosinophilic folliculitis varies depending on the severity. Your prior responses to medications may be considered, as well.

Possible treatments include:

Recap

Eosinophilic folliculitis causes itchy red bumps and pustules. It's common in late-stage HIV/AIDS. Treatments include anti-inflammatory drugs, dapsone, steroids, and light therapy.

Neuropathic Itching

Some people get nerve-related itching on the scalp. It's called a neuropathic itch. There is no rash—just itchiness. Scratching leads to scabs.

The cause of neuropathic itching is unclear. It's thought to be related to nerves in the skin. It can also be associated with conditions that are:

  • Metabolic
  • Orthopedic
  • Neurological
  • Infectious
  • Autoimmune

Neuropathic itching is often treated with systemic medications like Neurontin (gabapentin).

Recap

Neuropathic itching is caused by nerves. It's related to many medical conditions. Drugs like Neurontin can treat it.

Complications

Scabs form on the skin and scalp as part of a healing process. They protect new skin as it grows in over damaged areas.

It's important to leave scabs alone. When you pick at them, you can expose the delicate skin underneath to infection. It can also cause scarring. 

Depending on their size and cause, scabs usually fall off within a few days to two weeks.

Home Remedies

Home remedies aren't a substitution for treatments that your healthcare provider recommends. But in addition to those treatments, they may help reduce symptoms.

Some popular self-treatment products are:

  • Aloe vera: You can cut a leaf of an aloe vera plant to extract the gel or buy an OTC product. Apply it directly to the affected areas. Studies suggest it might be effective for mild to moderate psoriasis.
  • Tea tree oil: This essential oil is widely available. It's also an ingredient in some shampoos. Studies suggest it speeds up wound healing. It might help with seborrheic dermatitis and psoriasis.
  • Omega-3 supplements: These supplements are available OTC as capsules or liquid. They might help reduce inflammation from eczema and psoriasis. More research is needed say for sure whether they're effective.

Summary

Any rash or sores on your scalp may scab over. They may become infected, too. That's especially likely if you give in to the urge to scratch.

If you're unsure what's causing sores or scabs on your scalp, see a healthcare provider. Many OTC products may help. But it's important to know what you're treating first.

If OTC treatments don't help, you may be able to get prescription topicals or oral medication that clear up the problem. Home remedies may help with symptoms.

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 they're a sign of a condition that requires treatment. These include dermatitis, head lice, or psoriasis. 

  • How do I get rid of scabs on my scalp?

    Depending on the cause, you might be able to treat them with OTC medicated shampoos or ointments. You may also need prescription medications such as antibiotics or steroids. These treatments help relieve inflammation and redness, plus prevent infection. 

  • How do you stop picking at scabs on your scalp?

    Picking can raise your risk of scarring and infection. Topical products may help. Otherwise, try to distract yourself. Do something you enjoy or that keeps your hands busy.

    If you're picking at the scabs in your sleep, you might want to wear gloves at night. That stops scratching and gives the scabs a chance to heal.

Was this page helpful?
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Novak-Bilić G, Vučić M, Japundžić I, et al. Irritant and allergic contact dermatitis - skin lesion characteristics. Acta Clin Croat. 2018;57(4):713-720. doi:10.20471/acc.2018.57.04.13

  2. Johns Hopkins Medicine. Contact dermatitis.

  3. National Eczema Society. Skin infections and eczema.

  4. Blakely K, Gooderham M. Management of scalp psoriasis: current perspectives. Psoriasis (Auckl). 2016;6:33-40. doi:10.2147/PTT.S85330

  5. National Psoriasis Association. Treatment & care.

  6. National Psoriasis Foundation. Phototherapy.

  7. Centers for Disease Control and Prevention. Lice - Head lice - Treatment.

  8. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Dermatitis herpetiformis.

  9. Wikramanayake TC, Borda LJ, Miteva M, Paus R. Seborrheic dermatitis-Looking beyond MalasseziaExp Dermatol. 2019;28(9):991-1001. doi:10.1111/exd.14006

  10. American Academy of Dermatology Association. Seborrheic dermatitis: Diagnosis and treatment.

  11. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Seborrheic dermatitis.

  12. National Center for Advancing Translational Sciences, Genetic and Rare Diseases Information Center. Eosinophilic pustular folliculitis.

  13. Pereira MP, Wiegmann H, Agelopoulos K, et al. Neuropathic itch: routes to clinical diagnosisFront Med. 2021;8:641746. doi:10.3389/fmed.2021.641746

  14. El-Gammal A, Nardo VD, Daaboul F, et al. Is there a place for local natural treatment of psoriasis?. Open Access Maced J Med Sci. 2018;6(5):839-842. Published 2018 May 18. doi:10.3889/oamjms.2018.106

  15. Pazyar N, Yaghoobi R, Bagherani N, Kazerouni A. A review of applications of tea tree oil in dermatologyInt J Dermatol. 2013;52(7):784-790. doi:10.1111/j.1365-4632.2012.05654.x