Tuesday, May 17, 2022

Causes, Treatments, When to See a Doctor and More

  • Scalp scabs can be caused by everyday factors or by medical concerns such as head lice, fungal infections or a range of inflammatory skin conditions
  • Specially formulated shampoos, scalp serums and home remedies are all effective treatments
  • Medical treatments for severe and treatment-resistant cases include light therapy, medicated shampoos and prescription medications

Scalp scabs are crusted raised areas that develop over open sores on the head as they are healing; they can be itchy, uncomfortable and unpleasant. These scabs can often clear up on their own but depending on their underlying cause, may require professional treatment.

A wide range of treatments are available to help remedy scalp scabs. These include home remedies, over-the-counter (OTC) shampoos and serums, light therapy and prescription medications.

Everyday Causes of Scalp Scabs

Scalp scabs can be caused by everyday factors such as severe dandruff, irritation from excessive hair washing or minor injuries to the scalp; psychological stress can also play a role in causing scalp scabs to develop.


Dandruff is a common condition characterized by a flaky, itchy, dry scalp. It is typically triggered by psychological stress or changes in temperature and humidity. It is most common among young men but can affect people of any age or sex.

While dandruff is usually mild and causes minor irritation only, in some cases it can lead to the development of scaly patches and cause the scalp to bleed and become crusted with scabs.

Hair washing

Washing your hair too often or using a harsh formula can strip your scalp of its natural oils and damage the protective skin barrier. This can cause your scalp to become dry, inflamed, cracked and scabby.

Some shampoo ingredients, including formaldehyde, artificial preservatives and surfactants such as lauryl polyglucoside, can also trigger an allergic reaction. This can lead to the development of contact dermatitis, a condition that causes the skin to erupt with an itchy, painful rash that can also bleed and scab over.

Minor injuries

Injuries to the head caused by shaving, falling or other accidents can also cause the scalp to bleed and scab. The skin on the scalp is prone to tearing and bleeding from such injuries because it is thin, stretched across the skull and contains a high concentration of blood vessels.


Psychological stress can cause the development of certain inflammatory skin conditions that can in turn lead to scalp scabs. Stress is also known to disrupt wound healing, and may increase the amount of time it takes for existing scabs to resolve.

Medical Causes of Scalp Scabs

A number of medical conditions are linked to scabbing on the scalp, and include the following:

  • Eczema is a chronic condition that is characterized by redness, itching, blisters and sores, and can lead to scalp scabs
  • Head lice are small, parasitic insects that cling to the hair shaft and feed on blood from the scalp, causing itchiness and scabbing
  • Ringworm is a fungal infection that develops on the body and scalp; it can cause a range of symptoms such as hair loss, rashes, pus-filled areas and crusts
  • Seborrheic dermatitis is an inflammatory skin condition related to dandruff that can cause patches of skin on the scalp to become red, scaly, itchy and crusty
  • Psoriasis is a chronic skin disorder that primarily affects the scalp and causes raised plaques of scaly skin that can crack, bleed and scab over
  • Shingles is a skin condition caused by a reactivation of the varicella-zoster virus—the virus responsible for chickenpox—and causes a severe rash, blisters and scabbing

Scalp Scab Home Remedies

A number of natural remedies can treat scalp scabs caused by everyday factors. Some effective options include aloe vera gel, tea tree oil and warm compresses.

Aloe vera

Aloe vera has proven antibacterial, anti-inflammatory and wound healing properties. When applied to scalp scabs caused by dandruff, minor injuries and inflammatory skin conditions, it can help ease discomfort, stave off infection and accelerate healing.

To use aloe vera, cut open a leaf, remove a fingerful of gel and apply it to targeted areas of your scalp. Allow to rest for 1 hour, then wash it off with a mild shampoo. Repeat daily until symptoms have resolved.

Tea tree oil

Tea tree oil is an essential oil and has  antimicrobial properties. It can effectively reduce inflammation and support wound healing, and has demonstrated success in treating dandruff, psoriasis and seborrheic dermatitis. It can treat scalp scabs caused by any of these conditions.

Tea tree oil must be diluted before applying to your scalp. Blend 5–10 drops of the oil with 1/4 cup of almond, coconut or rosehip carrier oil for an effective and safe formula. Apply this mixture to your scalp, allow it to rest for 5 minutes, then wash it off with a mild shampoo.

Alternatively, you can purchase a tea tree oil shampoo or add 10–20 drops of the oil to a mild shampoo of your choice.

Warm compress

Apply a warm compress to scabby, itchy scalp skin to soothe discomfort, increase blood flow, and speed up the healing process. You can achieve this by soaking a hand towel in warm water, wringing it out, folding it and resting it on top of your head for up to 20 minutes.

Over-the-Counter Treatments for Scalp Scabs

Effective remedies for scalp scabs can be purchased OTC; these include specially formulated shampoos and scalp serums.


Shampoos are formulated with a wide variety of active ingredients to effectively treat scalp scabs. The shampoo that is best for you will depend on the underlying cause of your scabs.

If your condition is caused by dandruff or seborrheic dermatitis, choose an anti-dandruff shampoo containing selenium sulfide, coal tar or antifungal agents such as ciclopirox and bifonazole. These ingredients have all been demonstrated to provide effective relief.

If your condition is caused by over washing or eczema, you will benefit from mild shampoos that contain hydrating ingredients such as aloe vera and coconut oil. Avoid artificial fragrances, as these may worsen irritation and inflammation.

If a head lice infestation is the source of your scalp scabs, you will find effective relief from OTC shampoos containing insecticidal ingredients such as pyrethrins. Look for formulas that contain these ingredients in combination with piperonyl butoxide, a chemical that increases the efficacy of insecticidal compounds.

For scalp scabs that develop due to psoriasis, opt for shampoos that contain potent anti-inflammatory ingredients such as tea tree oil and iralfaris. Lastly, for scabs caused by ringworm, choose shampoos containing antifungal compounds such as ketoconazole. Formulations containing selenium sulfide can help to treat both psoriasis and ringworm.

Scalp serums

Scalp serums differ from shampoos in that they are applied to the scalp while it is dry and left to absorb into the skin. They provide a rich concentration of ingredients that work to moisturize the scalp. Scalp serums are an effective solution for scalp scabs that develop due to dandruff, seborrheic dermatitis or a dry scalp.

Scalp serums are typically formulated with hydrating ingredients such as aloe vera, hyaluronic acid, green tea and glycerin. They can also contain salicylic acid or other exfoliating ingredients that can eliminate dry, flaky skin.

When to See a Doctor

Speak to a dermatologist or health care professional about your scalp scabs if they persist despite treatment with OTC and home remedies, or if they cause you severe irritation. You should also seek professional care if you notice signs of infection, such as swelling, bleeding, a hot stinging sensation or the presence of pus.

Your care provider will be able to diagnose the underlying cause of your scalp scabs, provide daily care tips and offer you medical treatment. 

Light therapy

Light therapy (also known as phototherapy) involves the use of specific frequencies of light to treat a wide range of health concerns. A number of skin conditions that cause scalp scabs have been successfully treated using this technology.

Ultraviolet light therapy has been shown to effectively treat eczema and seborrheic dermatitis. Ultraviolet, near-infrared and red light therapy have also all demonstrated success in treating psoriasis. Although there is no conclusive evidence that light therapy can eliminate ringworm, one study found it had potential as a treatment method for fungal infections.

During a typical light therapy session, you will be seated or lying down in a dark room in front of  a light source that will emit one or more frequencies of light. You will wear protective goggles to prevent the light from harming your eyes. The session will last 20–30 minutes on average. There is no downtime after a light therapy treatment.

Prescription-strength shampoos

If OTC shampoos prove ineffective, prescription-strength medicated shampoos may offer better results. They can be used to treat persistent scalp scabs caused by head lice and psoriasis.

Shampoos containing lindane, an antiparasitic compound, are an effective treatment for head lice. Shampoos containing clobetasol, a medication with powerful anti-inflammatory effects, can effectively treat scalp scabs caused by psoriasis.

Oral medications

Oral prescription medications are a suitable option for treating scalp scabs caused by eczema, ringworm or shingles. They are typically available in tablet form, and are taken once daily for a 2–4 week period.

Ciclosporin, an immunosuppressant, is reserved for severe cases of eczema and for those who fail conventional treatments. Ciclosporin subdues the immune system response to ease uncomfortable symptoms.

For scalp scabs caused by ringworm, a range of oral antifungal medications can provide relief, including griseofulvin and terbinafine. Shingles are treated with oral antiviral medications such as acyclovir and valacyclovir.

Topical medications

Topical medications can help treat scalp scabs that develop due to head lice, ringworm or psoriasis.

Malathion, available in lotion form, is a fast-acting insecticide that kills lice by attacking their nervous systems. It is applied to hair and washed off after 8–12 hours.

Topical prescription medications for ringworm include clotrimazole, terbinafine plus a range of other potent antifungal agents. These are available in cream, ointment, gel and spray formats, and typically applied to affected areas twice daily.

Psoriasis can be treated with topical corticosteroids, medications with potent anti-inflammatory properties. Research shows combining topical vitamin D derivatives with corticosteroids may possibly enhance results.

Scalp Scab Prevention

The following tips will help reduce your risk of developing scalp scabs and prevent existing scabs from worsening:

  • Avoid hair dyes and bleach
  • Avoid psychological stress
  • Do not pick at any existing scabs
  • Do not scratch your scalp
  • Do not over wash your hair
  • Use gentle hair products with no artificial fragrances or preservatives


Scalp scabs can be caused by a range of everyday factors, including dandruff, over washing, minor injuries and stress. They are also a possible symptom of head lice, ringworm and inflammatory skin conditions such as eczema, seborrheic dermatitis, psoriasis and shingles.

Home remedies such as aloe vera, tea tree oil and warm compresses can treat scalp scabs that develop due to everyday causes. Depending on their ingredients, specially formulated shampoos can help treat a wide variety of conditions that cause scalp scabs to develop. Scalp serums containing hydrating and exfoliating ingredients can also provide relief.

If OTC and home remedies prove ineffective in treating scalp scabs, speak to your health care provider. They can offer medical treatments such as light therapy, and prescribe professional-strength medicated shampoos, topicals or oral medications.


  • Nowicki R. Współczesne leczenie łupiezu [Modern management of dandruff]. Pol Merkur Lekarski. 2006 Jan;20(115):121-4. https://pubmed.ncbi.nlm.nih.gov/16617752/
  • Lazzarini R, Costa LL, Suzuki NM, Hafner MFS. Allergic contact dermatitis by shampoo components: a descriptive analysis of 20 cases. An Bras Dermatol. 2020;95(5):658-660. doi:10.1016/j.abd.2019.12.009
  • Almulhim AM, Madadin M. Scalp Laceration. [Updated 2022 Feb 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541038/
  • Walburn J, Vedhara K, Hankins M, Rixon L, Weinman J. Psychological stress and wound healing in humans: a systematic review and meta-analysis. J Psychosom Res. 2009 Sep;67(3):253-71. doi:10.1016/j.jpsychores.2009.04.002
  • Cummings C, Finlay JC, MacDonald NE. Head lice infestations: A clinical update. Paediatr Child Health. 2018;23(1):e18-e24. doi:10.1093/pch/pxx165
  • Al Aboud AM, Crane JS. Tinea Capitis. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536909/
  • Borda LJ, Wikramanayake TC. Seborrheic Dermatitis and Dandruff: A Comprehensive Review. J Clin Investig Dermatol. 2015;3(2):10.13188/2373-1044.1000019. doi:10.13188/2373-1044.1000019
  • Nair PA, Patel BC. Herpes Zoster. [Updated 2021 Nov 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441824/
  • Feily A, Namazi MR. Aloe vera in dermatology: a brief review. G Ital Dermatol Venereol. 2009 Feb;144(1):85-91. https://pubmed.ncbi.nlm.nih.gov/19218914/
  • Satchell AC et al. Treatment of dandruff with 5% tea tree oil shampoo. J Am Acad Dermatol. 2002;47(6):852-855. https://www.jaad.org/article/S0190-9622(02)00313-4/pdf
  • Pazyar N et al. Tea Tree Oil as a Novel Antipsoriasis Weapon. Skin Pharmacol Physiol. 2012;25:162-163. https://doi.org/10.1159/000337936
  • Pazyar N, Yaghoobi R, Bagherani N, Kazerouni A. A review of applications of tea tree oil in dermatology. Int J Dermatol. 2013 Jul;52(7):784-90. doi:10.1111/j.1365-4632.2012.05654.x
  • Naldi L, Diphoorn J. Seborrhoeic dermatitis of the scalp. BMJ Clin Evid. 2015;2015:1713. Published 2015 May 27. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445675/
  • Fox LT, du Plessis J, Gerber M, van Zyl S, Boneschans B, Hamman JH. In Vivo skin hydration and anti-erythema effects of Aloe vera, Aloe ferox and Aloe marlothii gel materials after single and multiple applications. Pharmacogn Mag. 2014 Apr;10(Suppl 2):S392-403. doi:10.4103/0973-1296.133291
  • Agero AL, Verallo-Rowell VM. A randomized double-blind controlled trial comparing extra virgin coconut oil with mineral oil as a moisturizer for mild to moderate xerosis. Dermatitis. 2004 Sep;15(3):109-16. doi:10.2310/6620.2004.04006
  • Mazurek CM, Lee NP. How to manage head lice. West J Med. 2000;172(5):342-345. doi:10.1136/ewjm.172.5.342
  • Rossi A, Pranteda G, Iorio A, Mari E, Milani M. Efficacy of Iralfaris shampoo in the treatment of scalp psoriasis: a videodermoscopy evaluation prospective study in 70 patients. G Ital Dermatol Venereol. 2012 Dec;147(6):625-30. https://pubmed.ncbi.nlm.nih.gov/23149708/
  • Yee G, Al Aboud AM. Tinea Corporis. [Updated 2021 Dec 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544360/
  • Cohen PR, Anderson CA. Topical Selenium Sulfide for the Treatment of Hyperkeratosis. Dermatol Ther (Heidelb). 2018;8(4):639-646. doi:10.1007/s13555-018-0259-9
  • Alkeswani A, Cantrell W, Elewski B. Treatment of Tinea Capitis. Skin Appendage Disord. 2019;5(4):201-210. doi:10.1159/000495909
  • Gianeti MD, Mercurio DG, Campos PM. The use of green tea extract in cosmetic formulations: not only an antioxidant active ingredient. Dermatol Ther. 2013 May-Jun;26(3):267-71. doi:10.1111/j.1529-8019.2013.01552.x
  • InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Eczema: Light therapy and oral medications. 2017 Feb 23 [Updated 2019 Mar 20]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK424892/
  • Pirkhammer D, Seeber A, Hönigsmann H, Tanew A. Narrow-band ultraviolet B (ATL-01) phototherapy is an effective and safe treatment option for patients with severe seborrhoeic dermatitis. Br J Dermatol. 2000 Nov;143(5):964-8. doi:10.1046/j.1365-2133.2000.03828.x
  • Zhang P, Wu MX. A clinical review of phototherapy for psoriasis. Lasers Med Sci. 2018;33(1):173-180. doi:10.1007/s10103-017-2360-1
  • Secko D. Light as a defence against fungal infection. CMAJ. 2005;172(9):1174. doi:10.1503/cmaj.050365
  • Tan J, Thomas R, Wang B, Gratton D, Vender R, Kerrouche N, Villemagne H; CalePso Study Team. Short-contact clobetasol propionate shampoo 0.05% improves quality of life in patients with scalp psoriasis. Cutis. 2009 Mar;83(3):157-64. https://pubmed.ncbi.nlm.nih.gov/19363909/
  • Cohen JI. Clinical practice: Herpes zoster. N Engl J Med. 2013;369(3):255-263. doi:10.1056/NEJMcp1302674
  • Mosca M et al. Scalp Psoriasis: A Literature Review of Effective Therapies and Updated Recommendations for Practical Management. Dermatol Ther (Heidelb). 2021;11(3):769-797. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8163911/

» Show all

Latest Articles