Sores or scabs on the scalp are often harmless and clear up on their own. However, they can sometimes be a sign of a condition that may require treatment, such as psoriasis, contact dermatitis, or head lice.

In this article, we look at the possible causes of sores or scabs on the scalp and their treatment options. We also cover prevention tips and when to contact a doctor.

Psoriasis is a condition where the body replaces skin cells much faster than usual. This causes dry, discolored, and scaly patches of skin. These patches can occur almost anywhere on the body, including the scalp.

People with scalp psoriasis may experience itchy, flaky skin that looks similar to dandruff.

Some people with psoriasis find that certain things trigger or worsen their symptoms. Identifying and avoiding these triggers, which may include stress or certain foods, can help. For example, cigarette smoking typically worsens psoriasis and can make the condition harder to clear.

Learn about the treatment options for scalp psoriasis here.

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Contact dermatitis is a type of eczema that causes dry, scaly,blistered skin. It occurs when an irritating substance comes into direct contact with a person’s skin. When contact dermatitis develops on the scalp, the irritating substance is often a shampoo, hair product, or soap.

Contact dermatitis usually clears up on its own once a person identifies and avoids the irritant. If the rash is very painful or itchy, a doctor may prescribe a medicated shampoo or corticosteroid to relieve symptoms.

Unlike psoriasis, contact dermatitis occurs as a reaction to irritants. The condition will also not result in thick plaques as psoriasis would.

Learn more about contact dermatitis here.

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Seborrheic dermatitis is a common condition that causes itchy, flaky skin and may result in skin scales developing. This rash occurs in areas with lots of sebaceous glands. Sebaceous glands produce an oily substance called sebum.

Seborrheic dermatitis can appear greasy or scaly. In severe cases, it can cause raised bumps and scaly, white skin at the hairline. In adults with seborrheic dermatitis, stress, lack of sleep,or other triggers may cause symptoms to reoccur frequently.

Infants often develop a type of seborrheic dermatitis called cradle cap, which usually clears independently. However, caregivers may need to apply dandruff shampoo or other treatments to loosen the scales.

The greasy nature of seborrheic dermatitis can help people to distinguish it from contact dermatitis and psoriasis, which typically result in drier patches of discoloration and irritation.

Learn more about seborrheic dermatitis here.

A minor injury to the scalp can cause a cut or scrape. Intense scratching can also cause breaks in the skin and sores that may lead to scabs. A person can usually treat small cuts and scrapes at home. However, if the wound is large and painful, it may require medical care.

Avoiding irritants such as shampoo and styling products may help speed up healing.

Learn more about open wound care here.

An injury to the scalp can lead to infection, causing painful scabs, blisters, and swelling. Signs of infection can include:

  • pain or tenderness around the injury
  • skin discoloration around the injury
  • slow healing
  • oozing, crusting, and bleeding
  • fever

To ensure a quick recovery and reduce the risk of complications, it is important to contact a doctor for a suspected infection. Most bacterial infections respond well to antibiotics.

Read more about recognizing and treating infected wounds here.

Impetigo is a bacterial infection that can cause blisters and sores. The sores can be itchy and typically appear on the face and mouth. However, they can sometimes develop on the scalp or hairline.

Impetigo can occur after Staphylococcus or Streptococcus bacteria enter a cut or wound. The infection is highly contagious and common among young children.

Although mild impetigo may clear up on its own, prompt treatment is still critical. A doctor can prescribe topical or oral antibiotics to help:

  • prevent the infection from getting worse
  • reduce the risk of passing the infection to others
  • reduce the risk of complications

Learn more about impetigo here.

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Folliculitis is an infection of the hair follicles that can cause acne-like pimples or crusty sores. This condition is common after hair removal, especially shaving.

For people who shave their heads, the following may help prevent folliculitis on the scalp:

  • exfoliating the scalp before shaving
  • keeping the razor dry between uses
  • wetting the skin and using a cream or gel before shaving
  • always using a clean, sharp razor
  • applying an aftershave treatment

Unlike other conditions, folliculitis specifically affects the hair follicles. It appears more as dots rather than patches.

Learn more about folliculitis here.

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Acne is a skin condition that can cause pimples and other lesions to develop in body areas where there are hair follicles, including the scalp. Acne typically occurs when hair follicles clog with oil, dead skin cells, and bacteria, so people with oily hair may be more likely to develop acne on the scalp.

A person can treat scalp acne at home with medicated shampoos and regular hair washing. For severe or persistent acne, a doctor may prescribe acne medications or antibiotics.

Learn how to treat and help prevent scalp acne here.

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Head lice are tiny bugs that live in human hair. They lay their eggs near the bottom of the hair shaft and survive by feeding on tiny amounts of blood from the scalp.

Over time, these eggs hatch and create larger and larger infestations. Head lice are highly contagious, especially among children who come into close contact with each other or share brushes and hair care products. Around 6–12 million head lice infestations occur each year in the United States.

Head lice can cause intense itching. Scratching the scalp can cause sores and scabs that make the itching even worse. It is possible for these sores to become infected, and this may require antibiotic treatment.

People can treat head lice at home with medicated shampoos and by using special combs to kill lice and remove their eggs from the hair. It may take several treatments to get rid of a head lice infestation completely. It is best to follow the instructions that come with head lice products carefully.

Discover six home remedies for head lice here.

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Cysts are fluid-filled sacs that can develop just below the skin. They may also contain sebum and keratin, which are types of cells that make up the skin.

They can vary in size and may feel sore or tender. Cysts that develop around the hair follicles are known as trichilemmal or pilar cysts.

As a cyst grows, it may burst, causing sores and scabs. If infected cysts burst, this can spread the infection to other parts of the scalp. People should avoid manipulating cysts, as squeezing them may cause them to rupture internally, causing severe inflammation, swelling, and pain.

A person should contact a doctor if they suspect their cysts are infected. Antibiotics may be necessary to treat an infected cyst.

Learn about the symptoms and treatments for pilar cysts here.

Many causes of sores and scabs on the scalp are not contagious. And while medications and lifestyle remedies can help manage symptoms of skin conditions, including psoriasis and seborrheic dermatitis, they cannot prevent them entirely.

Some other causes of scalp sores are preventable. A few strategies include:

  • making children wash their hands regularly and avoid close contact with children who have infections
  • washing hair regularly to help prevent acne and reduce the risk of scalp infection after an injury
  • avoiding excessively touching or scratching the scalp
  • using shampoo that does not irritate or dry the scalp
  • contacting a doctor about scalp problems that do not go away on their own

Scabs and sores on the scalp are often harmless and will clear up on their own without treatment. However, people should speak with a doctor if the scabs or sores:

  • are very painful or itchy
  • do not start clearing up after a few days
  • keep reoccurring or get worse
  • are on a young child’s head
  • do not heal at all

People should also speak with a medical professional as soon as possible if:

  • a fever develops
  • the scalp becomes swollen
  • there are signs of infection, such as red streaks coming from the sores
  • the person with scabs or sores is receiving dialysis or cancer treatment

Some home remedies can reduce scalp irritation. However, treating the underlying cause is always the best way to get rid of scabs and sores.

Medicated shampoos can often help to reduce irritation in conditions that cause a dry scalp, such as scalp psoriasis and dandruff. Some people may also benefit from using natural remedies such as colloidal oatmeal, tea tree oils, and apple cider vinegar.

While home remedies may help to reduce symptoms, they may not treat underlying conditions. A dermatologist will be able to assess what is causing the scalp scabs or sores and prescribe treatments accordingly.

Learn more about home remedies for scalp irritation here.

There are many possible causes of sores or scabs on the scalp. While many lesions on the scalp are harmless, some can be a sign of an underlying medical condition.

Contact a doctor about sores and scabs that do not clear up on their own, keep reoccurring, or are very painful or itchy. A person should seek prompt medical attention if they suspect the scabs or sores may be infected.