A majority of us have gone through social embarrassment due to one of these reasons at some point in our lives - dandruff, lice, itchy scalp, etc. Did you know that one or more of these scalp conditions can lead to scabs?
If you’re wondering what this condition is and how serious it can be, read our article. We have listed all its causes, how to treat each of them and all the risks involved.
What Expert Says
“The dead cell collection on the scalp leads to dandruff, which is a prime cause of scabs. Salycilic acid and selenium sulfide reduces dandruff by controlling proliferation of keratinocytes.”
Dr. Harish Koutam, Chief Dermatologist, SkinKraft
What Is A Scab?
A scab is a small or big patch of skin that is excessively drier than the skin around it. Other healthy areas on the scalp will be smooth to the touch, while the scabs will be hard and rough. Scabs can be small and far apart, or several close patches together forming bigger scabs.
Causes & Treatments For Scalp Scabs
There can be several causes for scabs on the scalp - from dandruff and lice to contact dermatitis and seborrheic eczema. Depending on the cause, treatment can be chosen. Most times, the scabs clear up with topical treatments or targeted medication.
1. Lice On The Hair
Lice  can be quite contagious as they can fly from one person’s hair to another. Head lice causes itching and if you scratch too hard or for too long, it can cause scabs that may get infected.
Head lice are not carriers of any serious ailments and don’t cause serious harm. But, they need to be controlled and removed completely as it is unhygienic and could cause problems socially.
There are several OTC shampoos and medications available specifically to treat head lice. Look for ingredients like pyrethrin, dimethicone, etc. Once they fall off or are taken out they die in a few days; as they have nothing to feed on.
The same virus that causes chickenpox can cause shingles , as it remains dormant in the body if you have had chickenpox. When it gets reactivated, it causes shingles. They usually affect the skin, but can affect the scalp too at times.
Shingles appear like tiny blisters that become yellow and crusty over time. A rash due to shingles can be painful, and may lead to headaches or facial weakness. The condition may persist for several months.
Treatment for shingles must be prescribed by a dermatologist. The protocol could include topical ointments, oral antiviral and pain-killing medicines.
Word of Caution
If you have shingles, you should stay away from babies that are a few weeks old, people whose immune system is weak (cancer patients) and expectant mothers who have not had chickenpox earlier.
3. Eosinophilic Folliculitis
A non-contagious condition, eosinophilic folliculitis  leads to pus-filled sores that are itchy. When they heal, they leave patches of dark skin. This condition occurs when someone is in an advanced stage of HIV. The scabs can spread and recur as well.
Prescription medication, based on other health conditions, is prescribed. They include tablets that can control the infection and reduce the pain, and medicated ointments and shampoos to soothe the condition topically.
4. Contact Dermatitis
The reaction of the body to chemicals such as those present in cosmetics, hair colour, or shampoo leads to contact dermatitis . Other factors causing it include certain fabrics and jewellery, poison ivy, etc. When you scratch, it may bleed and lead to scab formation.
Contact dermatitis can clear up on its own. But if the allergic reaction is severe, antihistamines  and other relief providing OTC treatments may be prescribed.
5. Seborrheic Dermatitis (Dandruff)
Dandruff or seborrheic dermatitis  is one of the most common skin conditions that can cause scabs on the scalp. Itching, scabs, and dry flakes of skin that fall off and stick to the hair are symptoms. Scabs may be yellowish or white. Seborrheic dermatitis is not contagious.
It is a myth that poor hygiene causes dandruff; the exact cause is unknown. Shampooing everyday is also no guarantee that you won't have dandruff.
There are several OTC shampoos specifically for dandruff available. Some medicated lotions and ointments can be used as a supplementary treatment. When you select a shampoo to get rid of dandruff, look for ingredients like salicylic acid , selenium sulfide , pyrithione zinc  and tar .
There are also prescription shampoos that contain ketoconazole available in the market. But, those can cause irritation and itching; and can also change the feel and texture of your hair as side effects of long term use. If these symptoms persist, talk to your dermatologist.
Dandruff can be controlled; depending on the severity. It can take some months to a few years. In some cases, it remains a problem for a lifetime; though its intensity and appearance may recede and reappear time and again.
6. Scalp Psoriasis
A non-contagious skin condition, Psoriasis affects the skin anywhere on the body. When it affects the scalp, the symptoms are thick scabs all over the scalp. The scabs may be white, silver or grey. 
If the symptoms are not too severe, prescribed medicated shampoos can relieve the presence of the scabs and reduce the itching sensation. Shampoos to treat scabs on the scalp due to psoriasis should include tar and salicylic acid.
If the symptoms get more severe, or the shampoo does not reduce the itching, your dermatologist may prescribe steroids in the form of topical ointments or injections. Sometimes, the lymph nodes  may get swollen, in which case your doctor may suggest antimicrobial creams.
Usually, acne causes pimples and blocked pores on the face and in areas like the scalp where hair follicles are present. When they get clogged due to sweat, oil, dead cells or bacterial infection, it may lead to acne and scabs on the scalp.
Medicated shampoos and frequent hair baths can reduce the presence of scabs and acne on the scalp. If the condition is severe, the dermatologist may prescribe anti-acne treatments or even antibiotics.
8. Seborrheic Eczema
This condition, whose cause is unknown, leads to scabs on the scalp. The scabs are usually very itchy and the scalp can become red. When it is severe, seborrheic eczema  spreads to other parts of the body, starting with the neck, the area behind the ears and the face.
It is best to consult a dermatologist for this condition. A topical ointment to relieve symptoms may be prescribed. If looking for a shampoo to treat scabs on the scalp, look for ingredients like tar, salicylic acid and selenium sulfide.
Did You Know?
Statistics show that 50%  of the people who have psoriasis, will have scalp psoriasis.
Shingles are not contagious but if someone without any history of chickenpox comes close to someone with shingles, they could get chickenpox as it is caused by the same virus.
Our chief dermatologist, Dr. Harish Koutam says, “Impetigo is a common superficial bacterial infection of the skin. Streptococcus or Staphylococcus species are the usual causative organisms.The common type of impetigo shows subcorneal collections of neutrophils, serum and parakeratotic foci resulting in scab formation.”
Symptoms include sores and blisters. The sores are usually itchy and appear on the face, and the area around the mouth. They may occur on the scalp or along the hairline too. 
This infection is caused when the Staphylococcus or Streptococcus bacteria enters open skin due to a wound or a cut. It is an extremely contagious condition and can spread from one person to another. It occurs frequently among younger children.
A mild infection can recede on its own. But if mild or severe, the condition needs immediate medical treatment. The doctor/dermatologist may prescribe an antibiotic cream or lotion and tablets to control and prevent it from getting worse, spreading or causing other complications.
10. Scalp Ringworm
A fungal infection causes the condition known as scalp ringworm . When it affects the scalp, it leads to a rash that is very itchy and red in colour.
Medical treatment is vital here as the condition needs prescription medicine. The dermatologist will prescribe treatment based on the diagnosis.
11. Lichen Planus
Lichen planus is a skin condition that causes red or purple bumps. When it reaches your scalp, the condition is called lichen planopilaris. It affects the scalp badly and leads to hair damage. The hair damage slowly causes permanent hair loss. Most people get lichen planus in their middle age. Generally, a skin biopsy is required to diagnose the skin condition.
In a few cases, lichen planus goes away on its own without any treatment. But usually, corticosteroid creams or oral steroids are provided by the doctors. Sometimes, the steroids are injected to get more efficient results.
Why Do Scabs Itch?
The scabs are usually caused due to an allergic reaction to an irritant, dry and dead skin, or formed due to other skin conditions. All the conditions mentioned above are symptomised with an urge to itch or itchy skin. When you scratch frequently, it can cause a scab on the scalp.
Potential Complications Of Scabs
- May be painful
- Can cause inflammation
- Can spread to other parts of the body
- May have pus and are infected
- Hair loss
- Allergic reactions can get intense due to contact with the irritant
Scabs on the scalp can form due to various reasons. The most common one is dandruff. However, with timely treatment using OTC / prescription shampoos and medications, scabs on the scalp can be controlled before they cause further damage. Always consult your doctor before you try any new treatment.
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