Red spots on the scalp can occur due to acne, psoriasis, folliculitis, and other conditions. Medical options can address underlying causes, while home treatments, such as zinc, can help manage symptoms.

This article explores some of the conditions that may cause red spots to form on the scalp, what they may look like, and what treatments may help.

Various skin conditions may cause red spots on the scalp:

Scalp psoriasis

According to the National Psoriasis Foundation, over 60% of people with psoriasis have scalp psoriasis.

Scalp psoriasis can affect the scalp, hairline, the back of the neck, the forehead, or the skin behind the ears.

Symptoms include:

  • itching
  • bleeding
  • temporary hair loss
  • soreness or burning sensation
  • red patches on the scalp
  • fine silvery-white scales that look like dandruff
  • thick, crusty plaques that cover the entire scalp

Cold temperatures, dry air, and stress can trigger a scalp psoriasis flare-up.

Learn more about scalp psoriasis here.

Folliculitis

Folliculitis is a skin infection that affects the hair follicles. It can occur anywhere on the body except the palms of the hands and soles of the feet.

Folliculitis looks similar to an acne breakout. Its spots may have a red ring around them. It occurs due from damage to hair follicles, which allows germs to enter and trigger an infection.

Hair follicle damage may occur if a person rubs or touches their skin frequently, wears tight clothing or hats often, shaves regularly, or if the skin gets damp or hot and rubs against other areas of skin or clothing.

Sometimes, folliculitis can make the skin painful or itchy, but a person may not experience any symptoms aside from the skin spots.

Learn more about scalp folliculitis here.

Seborrheic dermatitis

Seborrheic dermatitis is a type of eczema that can look similar to psoriasis. A person with this condition usually has a dry, red scalp, with thick, greasy, white, or yellow scales.

In teenagers and adults, seborrheic dermatitis can develop where the skin produces more oil. It can also occur on the sides of the nose, around the eyebrows and scalp, and on the male chest.

Learn more about seborrheic dermatitis here.

Ringworm

Ringworm is a fungal infection that can occur anywhere on the body.

Its appearance depends on its location on the body. Ringworm on the scalp may result in:

  • intense itchiness
  • a scaly bald patch
  • widespread baldness with thick, crusty patches on the scalp
  • black dots on the bald patch
  • open sores that leak pus
  • a raised area of skin that is spongy and inflamed
  • swollen lymph nodes

Learn about scalp ringworm, or tinea capitis, here.

Acne

Most acne pimples develop on the face, neck, back, chest, and shoulders.

The exact cause of acne is not known, but experts believe that changes in hormone levels, certain medications, make-up, and hereditary factors may play a part.

Acne can show up in several different ways:

  • whiteheads: pimples underneath the surface of the skin
  • blackheads: pimples that appear on the skin surface and look black
  • papules: pink, tender bumps
  • pustules: pimples that are red at the bottom and have pus on top
  • nodules: large, solid, and painful bumps deep under the skin
  • cysts: deep, painful pimples filled with pus that can cause scarring

Learn more about scalp acne here.

Lichen planopilaris

Lichen planopilaris is a type of hair loss that is due to a skin disease called lichen planus. Lichen planopilaris destroys hair follicles while scar tissue grows over them, stopping hair from growing.

Experts believe problems in the immune system trigger this condition. Symptoms include:

  • redness of the hair follicle
  • scaling of the hair follicle
  • rough scalp texture
  • smooth and shiny skin where hair follicles have been destroyed

It often develops in patches but can affect large areas of the scalp.

Head lice

Head lice are small, grey or brown insects that live on the scalp. They can affect anyone with any hair length.

A person usually spreads lice through head contact. Those who share hats, hairbrushes, combs, or pillows can make it easier to spread these insects.

Symptoms include:

  • small yellow or white eggs that attach close to the base of the hair
  • brown or grey lice
  • louse droppings that look like dark specks on pillows or clothing
  • scratches on the scalp
  • sticky or weeping skin on the scalp
  • itchy pink bumps around the scalp edge and the back of the neck
  • enlarged glands on the neck

Learn more about head lice here.

Not every scalp condition has a cure, and treatments may focus on managing the symptoms.

Medical treatments

Various treatments can help with several of the following triggers for spots on the scalp:

Acne: People can treat acne that occurs on the scalp with medicated shampoos. They can also be effective against scalp psoriasis, seborrheic dermatitis, and bacterial and fungal infections of the scalp.

Scalp psoriasis: People can use topical steroid creams and tars to treat scalp psoriasis. Phototherapy, which uses UV light to slow skin cell growth, can also improve symptoms.

Seborrheic dermatitis: To treat seborrheic dermatitis, mineral oils or petroleum jellies are available for infants, while adults can use anti-fungal cream and medicated shampoos. In severe cases, doctors may prescribe topical corticosteroids, while non-steroid creams are also available.

Lichen planopilaris: People can treat lichen planopilaris with steroid injections, topical gels or creams, or oral medications.

Home treatment

People can manage seborrheic dermatitis at home by regularly moisturizing and washing the skin with gentle zinc cleansers.

To treat head lice infestation, people can use insecticides in gels, lotions, or sprays. They should regularly wash combs and brushes in hot water to help stop the spread of lice. Caregivers should also routinely check for lice in school-age children.

If symptoms do not clear with over-the-counter medications or home treatments, it may be time to see a doctor.

Infections can become serious, and medical professionals can prescribe antibiotics or refer people to specialist help if necessary.

Doctors can also help people with scalp conditions receive the correct diagnosis.

Many scalp conditions are treatable, and they can affect anyone. A variety of creams, lotions, and other techniques, such as light therapy or steroid injections, can help ease symptoms and clear up certain scalp issues.