Scabs and sores on the scalp can be itchy and unpleasant. Scratching generally makes them worse and increases your chances of infection. In many cases, scabs and sores on the scalp clear up on their own or with over-the-counter (OTC) treatments.

Most of the time, they don’t indicate serious illness. If you can’t identify the cause of your scabs and sores, 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 is an allergic reaction to something you’ve touched.

An allergic reaction can be caused by jewelry or health and beauty products such as shampoo and hair dye. Certain materials, such as 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 such as 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.

Contact dermatitis isn’t contagious.

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 condition isn’t contagious. and its cause is unclear. But it isn’t usually a sign of poor health, and it has nothing to do with cleanliness. You can shampoo your hair every day and still have dandruff. It can even be seen in newborn babies, in a condition known as crib cap.

It can take a long time to get dandruff under control, however. In some cases, it may become a lifelong problem that comes and goes.

You can buy OTC medicated shampoos and topical ointments designed to treat dandruff. There are many available options for medicated dandruff shampoos. Some ingredients to look for when selecting a shampoo are:

  • pyrithione zinc
  • salicylic acid
  • selenium sulfide
  • tar

You may need to try a few types of medicated shampoo in order to find the one that effectively controls your dandruff.

Shop for anti-dandruff shampoos, ointments, or lotions.

If OTC medicated shampoos don’t help, you can also try a prescription shampoo, such as one containing ketoconazole. This drug can have side effects such as changes in hair texture, itching, or irritation. Always be sure to follow package directions carefully. Report any problems to your doctor or pharmacist.

Psoriasis is a noncontagious skin condition that can affect various parts of your body. It can cause thick, silver-gray scabs all over the scalp. Over 50 percent of people with psoriasis have scalp psoriasis, according to the National Psoriasis Foundation (NPF).

Mild cases often benefit from medicated shampoo designed to treat the scalp and ease itching. Ingredients to look for in OTC medicated shampoos include salicylic acid and tar.

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.

Shop for psoriasis shampoos.

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 condition isn’t contagious and the cause isn’t known.

Eczema can be treated with medicated shampoos, which help to loosen scales. Ingredients to look out for in OTC medicated shampoos are:

  • pyrithione zinc
  • salicylic acid
  • selenium sulfide
  • tar

Shop for eczema shampoos.

Prescription-strength topical ointment may also be helpful.

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.

Creams and lotions don’t work for treating ringworm of the scalp. Treatment includes oral antifungal medications that will need to be taken by mouth for one to three months. Examples include griseofulvin (Gris-PEG) and terbinafine (Lamisil). Your doctor may also recommend using a medicated shampoo, such as one containing selenium sulfide, during your treatment period. Untreated, ringworm can lead to extreme inflammation, scarring, and hair loss that may be permanent.

Shop for antifungal shampoos or selenium sulfide shampoos.

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.

Head lice can be very contagious. If someone in your household has head lice, everyone who’s been in close physical contact with them should be checked. Head lice can be treated with OTC medications specifically designed for this purpose.

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 person with lice 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 Centers for Disease Control and Prevention (CDC) suggest soaking hairbrushes and combs in 130°F (54.4°C) for 5 to 10 minutes.

Shop for lice treatments.

Lichen planus is an ailment that causes red or purple bumps on the skin. It isn’t contagious. When it affects the scalp, it’s called lichen planopilaris. It can lead to hair loss, also known as alopecia, or permanent scarring. The hair loss caused by lichen planopilaris is typically permanent.

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. Antihistamines can help with the itching.

Shingles is a noncontagious condition caused by the same virus that causes chickenpox. After you have chickenpox, the virus remains dormant in your body. If activated, you get shingles. It mainly affects the skin of the body, 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 is a skin and scalp condition that tends to affect people who have HIV or AIDS. The condition isn’t contagious. 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. Anyone who has HIV or AIDS and develops skin or scalp scabs should see their healthcare provider.

Dermatitis herpetiformis is a very itchy skin and scalp condition that is observed in people with celiac disease or gluten allergies. The condition isn’t contagious. Dermatitis herpetiformis causes groups of red, intensely itchy bumps. Typically, a burning sensation is felt before the bumps appear.

While the bumps do scab over and heal in a week or two, new bumps can continue to form. The prescription medication dapsone (Aczone) may be used to relieve symptoms. However, following a strict gluten-free diet is the only effective way to treat the underlying disease.

Lupus is an autoimmune disease in which your body creates antibodies that attack healthy tissue. In addition to attacking healthy parts of your body, these antibodies can cause pain and inflammation.

Lupus is chronic and noncontagious. About two-thirds of people with lupus will also notice that the disease has an effect on their skin. Lesions or rashes may appear in areas that are commonly exposed to the sun, such as your head, face, and neck. If the lesions occur on the scalp, hair loss and scarring can occur. Treatment of lupus-related skin conditions can include corticosteroid creams or calcineurin inhibitors. Medications such as dapsone may be used for more moderate cases.

Skin cancer most commonly develops in areas that are frequently exposed to the sun, such as the:

  • scalp
  • face
  • neck
  • arms
  • hands

There are several different types of skin cancer, none of which are contagious. You should look out for any changes in the skin of your scalp, including sores that don’t heal, patches that are raised or scaly, or spots that change in color, size, or shape.

Your doctor will perform a skin exam and take a biopsy of the affected area to help them diagnose your condition. Treatment for skin cancer is dependent on the type of skin cancer, the stage of the cancer, and your overall health.

Some home and alternative remedies may provide relief from the pain of scabs and sores.

Tea tree oil

This natural oil can be found as a stand-alone product or as a component of shampoos. However, it may cause an allergic reaction in some people. Studies have found that it’s effective for conditions such as dandruff and psoriasis. Other uses of tea tree oil, such as in treatment of head lice, aren’t supported by scientific studies.

Shop for tea tree oils and shampoos.

Aloe vera gel

You can obtain this gel directly from a cut leaf of an aloe vera plant or as an OTC product. You should apply the aloe vera gel directly to the affected area of your scalp. Studies have found that aloe vera gel may be effective for psoriasis.

Shop for aloe vera gel.

Fish oil, or omega-3, supplements

These supplements can be found in pill form. They may help to lessen inflammation in conditions such as eczema and psoriasis, but scientific evidence is mixed and more research needs to be performed.

Shop for omega-3 supplements.

Other helpful tips

You should also be sure to clean your hair and scalp regularly if you have scalp scabs.

Try to shampoo each day or every other day until your symptoms subside. If you’re using an OTC medicated shampoo, you should always follow the instructions on the packaging. It’s important that you leave shampoo on for the recommended amount of time so that the active ingredients can get to work.

You should also be aware that shampoos containing tar could discolor light hair. If you have light-colored hair, you may want to try other products first.

While you’re treating your scalp scabs, you should also try to avoid any beauty or styling products that could irritate your condition.

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’ve tried OTC medicated shampoos or home remedies for several weeks and are still experiencing symptoms, you should talk to your doctor. They may be able to diagnose your condition by a simple examination of your scalp. They may also scrape off skin cells or take a biopsy to aid in making a diagnosis.

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