How to Manage Scalp Folliculitis

There’s no cure or any approved drug to help with symptoms, although several medications and surgical procedures look promising for future treatment. Still, your hair might regrow on its own. Medications for hair growth work for some people, but they don’t keep you from getting new patches. It’s important to protect exposed skin — especially on top of your head — from direct sun with hats, scarves, or sunscreen.

What can cause sores or scabs on the scalp?

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.

In the U.S., healthcare spending accounts for 17.7% of the Gross Domestic Product (GDP), or the total value of goods and services produced by the entire nation for the entire year, according to the Centers for Medicare & Medicaid Services.

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.

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.

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.

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.

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

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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.

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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.

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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.

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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.

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.

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.

Last medically reviewed on March 1, 2022

• Dermatology
• Psoriasis
• Atopic Dermatitis / Eczema
• Infectious Diseases / Bacteria / Viruses

How we reviewed this article:

Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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  https://www.aad.org/public/everyday-care/itchy-skin/itch-relief/relieve-scalp-itch
• Acne: Tips for managing. (n.d.).
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• Al Aboud, D. M., et al. Pilar cysts. (2021).
  https://www.ncbi.nlm.nih.gov/books/NBK534209/
• Contact dermatitis. (n.d.).
  https://nationaleczema.org/eczema/types-of-eczema/contact-dermatitis/
• Cradle cap. (2019).
  https://www.nhs.uk/conditions/cradle-cap/
• Folliculitis. (n.d.).
  https://www.aocd.org/page/Folliculitis
• Head lice and nits. (2021).
  https://www.nhs.uk/conditions/head-lice-and-nits/
• Head lice: Epidemiology & risk factors. (2019).
  https://www.cdc.gov/parasites/lice/head/epi.html
• Impetigo: Diagnosis and treatment. (2021).
  https://www.aad.org/public/diseases/a-z/impetigo-treatment
• Integrative approaches to care. (2020).
  https://www.psoriasis.org/integrative-approaches-to-care/
• Overview: Contact dermatitis. (2019).
  https://www.nhs.uk/conditions/contact-dermatitis/
• Scalp psoriasis: Diagnosis and treatment. (n.d.).
  https://www.aad.org/public/diseases/hair-and-scalp-problems/scalp-psoriasis
• Seborrheic dermatitis: Overview. (n.d.).
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• Skin cyst. (2020).
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How to Manage Scalp Folliculitis

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Folliculitis is a common inflammatory skin condition affecting your hair follicles. It’s usually caused by a fungal or bacterial infection.

The infection occurs when you damage your hair follicles, which are the openings in your skin that hold the roots of your hair. This can affect any part of your body with hair, including your scalp.

The condition isn’t contagious, and you can usually treat it at home. But in some cases, the infection can spread to other follicles and cause scarring or permanent hair loss.

Folliculitis initially causes small, red bumps that look similar to an acne breakout. Over time, it may spread to other follicles and the bumps may get larger and more inflamed.

While it can affect any part of your scalp, it often begins along your hairline.

Other signs and symptoms of scalp folliculitis include:

• clusters of tiny, red bumps on your scalp that may have a white tip
• sores with yellowish-brown scabs
• sores that drain pus
• itching
• burning or stinging sensation
• pain or tenderness

Folliculitis is caused by damage to your hair follicles, which leaves them vulnerable to infection-causing bacteria and fungi.

Many things can damage the hair follicles on your scalp, such as:

• frequently scratching or rubbing your head
• tugging on or twisting your hair
• wearing hairstyles that pull your hair, such as tight ponytails or braids
• frequently wearing hats
• shaving your head
• wearing sports helmets
• using a lot of hair products, which can build up over time

Several things can also increase your risk of developing scalp folliculitis, including:

• having acne or dermatitis
• being a male with coarse or curly hair
• having a weakened immune system due to an underlying condition
• taking certain medications for acne, including steroid creams or antibiotic therapy

You can usually take care of mild cases of folliculitis at home. The most important thing is to stop doing anything that may have caused it in the first place.

For example, if you shave your head frequently, try taking a few weeks off. If your folliculitis clears up, you may want to change your shaving technique.

You can also try:

• Warm compress. Applying a warm compress or warm, damp cloth to your scalp a few times a day can help to soothe your scalp and drain any pus.
• Antibacterial soap. If your scalp folliculitis is located along your hairline, gently wash the skin twice daily with antibacterial soap and dry the area with a clean towel.
• Anti-dandruff shampoo. Washing your scalp with an anti-dandruff shampoo that contains antifungal agents, such as ketoconazole, ciclopirox, or tea tree oil, may be helpful. You can buy anti-dandruff shampoo on Amazon.
• Cortisone cream. A cortisone cream, also available on Amazon, can help to soothe the inflammation and itch of scalp folliculitis.
• Antibiotic ointment. You can also try applying an antibiotic ointment, like Neosporin, to the area to help target bacteria.
• Lukewarm water. Avoid washing your hair or scalp with hot water, which can further irritate your scalp. Stick to lukewarm water instead.
• Washing. Wash any items, such as hats, bedding, or combs, that have come into contact with the affected part of your scalp.

Once your condition has cleared up, be sure to practice proper scalp hygiene. Wash your scalp regularly to avoid a buildup of hair products and oils that can clog or irritate your hair follicles.

If you shave your head with a hand razor, consider switching to an electric razor and using a soothing lotion after each shave.

While folliculitis is often treatable at home, some cases may require a trip to the doctor. Make an appointment if you aren’t noticing any improvement after a few days of home treatment, or if things seem to be getting worse.

You should also see a doctor if:

• sores continue to worsen or spread after two full days of home treatment
• your skin is red or painful around the hair follicles
• you develop a fever of over 100°F (38°C)
• your folliculitis was caused by shaving, but you’re not able to stop shaving

You may need a prescription antifungal cream or oral antibiotic, especially if you have a weakened immune system or have recurring folliculitis.

Folliculitis of the scalp can be uncomfortable, but you can usually manage it at home.

If you aren’t noticing any improvement after a few days, or things seem to be getting worse, make an appointment to see a doctor. You may need a prescription treatment.

Last medically reviewed on February 15, 2019

Conditions That Affect Your Scalp

Psoriasis is a long-lasting condition that causes a dry, itchy buildup of skin cells that may crack and bleed. It makes your skin flake, and you can have it on different parts of your body. About half of all people with it have it on their scalp.

Treatment for Scalp Psoriasis

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Your doctor may give you special shampoo or medication to put directly on your scalp. You also may get pills to help with inflammation and itching. Another treatment option is to shine natural or artificial ultraviolet light on your skin. It can help clear up the painful patches.

Dry Scalp

3/18

It sounds simple, but this can have a big effect. It can itch and flake, and when the skin breaks — from cracking or scratching — bacteria can get in and cause an infection. It’s more common in dry climates, and it’s more likely to happen as you get older. You also can have this issue if you wash your hair too often or use harsh hair products that strip out natural oils.

Treatment for Dry Scalp

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Lifestyle changes can make a difference. You may try washing your hair less often or using a milder shampoo — ask a doctor or pharmacist about what might work best for you. In severe cases, or when the dryness is caused by a treatable condition, your doctor may suggest medication.

Dandruff

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Small pieces of skin can “flake” off your scalp and leave a telltale sprinkling of white on your shoulders. Overly dry — or oily — skin can cause it, as can certain illnesses, like HIV or Parkinson’s disease. It also can be a reaction to certain soaps or shampoos or to a fungus on your scalp.

Treatment for Dandruff

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Your treatment will depend on the cause. For example, if it’s a reaction to certain shampoos, you may simply switch products. Or you can try an over-the-counter dandruff shampoo or rinse to manage it. If it doesn’t go away, talk with your doctor.

Ringworm

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Despite the name, no worms are involved in this condition. It’s a fungus that can infect your skin or scalp and cause itchy, scaly, bald patches on your head. It’s easy to get it from someone else, and it’s common in toddlers and children.

Treatment for Ringworm

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Your doctor may give you drugs that you take by mouth, or special shampoos, rinses, or creams to use on your head. The problem should be completely gone after treatment, as long as you don’t catch it again.

Lice

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They’re tiny insects that live in your hair and feed on blood from your scalp. It sounds terrible, but they’re not dangerous — just contagious, annoying, and itchy! They’re also sometimes hard to get rid of.

Treatment for Lice

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Special shampoos or rinses can kill lice and the eggs they lay. You can get some of these over the counter, but higher-strength ones need to be prescribed by your doctor. Your scalp might itch for a while, even after the lice are gone.

Folliculitis

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This is a common skin condition that happens when hair follicles — the tiny holes where your hair grows — get irritated, usually after a bacterial or fungal infection. Small red or white-headed bumps often show up around the follicles. It can spread and turn into crusty sores that don’t heal fast. In severe cases, it can cause hair loss and scarring.

Treatment for Folliculitis

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It’s treated with medicated creams or shampoos or light therapy. In rare cases, minor surgery may be needed.

Alopecia Areata

13/18

This happens when your immune system, which normally protects your body from invaders like viruses and bacteria, mistakenly attacks your hair follicles. It can lead to hair loss, often in patches.

Treatment for Alopecia Areata

14/18

There’s no cure or any approved drug to help with symptoms, although several medications and surgical procedures look promising for future treatment. Still, your hair might regrow on its own. Medications for hair growth work for some people, but they don’t keep you from getting new patches. It’s important to protect exposed skin — especially on top of your head — from direct sun with hats, scarves, or sunscreen.

Seborrheic Dermatitis

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It causes “scaly” patches of skin and stubborn dandruff and may also affect oily areas of your body, like your face, upper chest, and back. It can be itchy, but it’s not serious.

Treatment for Seborrheic Dermatitis

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It’s a long-term condition, but symptoms can be treated with creams, drugs, and special shampoos.

Cradle Cap

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This is a kind of seborrheic dermatitis that happens to babies. It isn’t painful or itchy like the adult version, but it can be alarming to see the thick, crusty, yellow scales, which aren’t easy to remove, on your baby’s head.

Treatment for Cradle Cap

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It usually clears up on its own. You can wash it daily with a mild shampoo to loosen it. If it’s still there after a few weeks or looks like it’s getting worse, see your baby’s doctor.

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Journal of Investigative Dermatology: “A Practical Guide to Scalp Disorders.”

Mayo Clinic: “Cradle Cap,” “Seborrheic Dermatitis,” “Psoriasis,” “Dry Skin,” “Dandruff,” “Ringworm Scalp.”

Nemours Foundation: “Head Lice.”

National Institutes of Health: “Androgenetic Alopecia,” “Questions and Answers about Alopecia Areata.”