Why Do I Get Scabs On My Head?

Odious and unattractive visible scabs on the scalp that ruin your chance at being confident or getting intimate? Well, no more embarrassment when a solution is available. Follow me to see what the gossip is about.

If you have scabs on your head, here is an overview of everything about scabs, what scabs are, which health conditions lead to the formation of scabs and how scabs can be prevented and treated. 

Scabs on the head or scalp consist of dead, rough skin cells from the scalp. Scabs on a dry scalp are a result of accumulating dead cells, and they are associated with several health conditions.

What are scabs?

Scabs can be on the skin, but can they be on a person’s head, too? Scabs on the head or scalp are identified as dead, rough skin cells from the scalp. If you do have the symptoms of scabs present on your head, here is some research to go through. Let’s learn about the overview of scabs and the severe conditions leading to them, along with their prevention and treatment. 

Causes of scabs on the head

Scabs may be caused by many things, such as hard water deposits/calcium. YES! Your bathroom water could be the reason why your healthy scalp forms scabs and experiences itchiness and redness. When you shower with bathroom water, the limescale deposited contains calcium and magnesium. The calcium is then trapped in the scalp and leaves the dry scalp in need of hydration and nourishment. 

Hard water may also lead to psoriasis and eczema on the scalp; these conditions tend to occur when people experience hard water build-up effects characterised by itchiness, flakiness and dryness of the scalp. As hard water stops the scalp from absorbing moisture, dermatitis may also arise.  Furthermore, hard water build-up effects can affect areas other than the scalp. Due to hard water minerals blocking pores on the scalp and skin, common toiletries will no longer be able to clean and hydrate affected areas. As a result, the scalp may produce excessive oil, which further blocks pores and can lead to acne.   

Management and treatment for scabs on the head

For adults, the best treatment is anti-fungal shampoos that come with any type of application containing ketoconazole that can be used twice a week. This type of anti-fungal shampoo specifically targets Malassezia yeast and is used for its symptoms. In children, it is advised to use home remedies like mineral oil or Aloe vera to hydrate the cradle cap.

Medicated shampoos with salicylic acid are highly effective in countering seborrheic dermatitis and psoriasis dandruff. In general, the FDA also shows positive reviews on medicated shampoos manufactured for tackling dry and flaky scalp skin.

Another reason why hard water deposits may cause dermatitis is that they contain chlorine, which increases the risk of contact dermatitis. To tackle the hard water scabs and dryness, detox shampoo that specifically targets water deposits and other forms of treatment, like a cream containing ceramides, are recommended. 

Conditions associated with scabs

• Seborrheic dermatitis 
• Psoriasis and Eczema 
• Eosinophilic folliculitis 
• Impetigo
• Hair transplant 

Seborrheic dermatitis

Let’s break seborrheic dermatitis down step-by-step. Seborrheic dermatitis is common in the oily scalp area. The scalp gets inflamed and produces dandruff, leading to eczema and psoriasis scalp with patches. This condition in young children is known as cradle cap, and hair loss isn’t one of its symptoms.  

The reason for the inflammation is that the scalp is irritated by dermatitis, while Malassezia yeast is responsible for dermatitis and severe dandruff. Melassezia yeast is commonly found on the scalp and can invade and inflame the scalp when the innate system (first barrier of protection) is not effective anymore. The yeast appears when sebum flows. Sebum is a fatty acid that contains oily substances and prevents skin infection. Low sebum flow can make the scalp dry, and the yeast will balance out by colonising the dry area to obtain an oily scalp, which gives a cradle cap to infants and the red scalp and rash symptoms in adults.^1,2

Known facts: Seborrheic dermatitis is common in patients of certain races and ethnicities due to hypopigmentation, which means an individual has a low melanin level.⁴

Psoriasis and eczema scabs

Psoriasis is another cause of scabs. Psoriasis and conditions with similar symptoms produce plaques of scabs on the scalp that are thicker and drier. Psoriasis extends to the hairline, the elbow, the back, and the knees and patients with psoriasis also have a risk of losing hair in general. 

Psoriasis is believed to develop when the cell cycle induces more cells than usual. The immature cells are manufactured in 3 to 7 days compared to the usual process that takes 3 to 4 weeks. T-cells which stop bacterial infection are involved in the process of psoriasis development by a complex mechanism and the immune system balances the cell number by stimulating more cells.⁵  

Psoriasis and eczema scabs are confusing in their symptoms of producing patches and redness on the scalp. Eczema scabs, in particular, form a protection layer over the mutated scalp. The layer of protection allows bacterial infection, for instance, to colonise the scalp. 

Psoriasis vs eczema

The difference is that psoriasis occurs in early childhood, whereas eczema appears later in adulthood. There is also a difference in patients’ reactions to climate; Eczema patients can be overwhelmed in hot weather.^6,7

Another fact about psoriasis is that it is associated with depression from not feeling assertive when the patches are visible. Psoriasis is not contagious, so there is no risk of getting it from being intimate with psoriasis patients.

Contact dermatitis

Contact dermatitis is an eczema type influenced by allergies to substances such as shampoos, hair dyes or other hair products. Patients with contact dermatitis are allergic to chemicals in hair dye and shampoo in contact with the scalp. The symptoms are similar to eczema and the prevention is simply to stop using shampoo or hair dye products that result in an allergic reaction.⁸ 

Eosinophilic folliculitis

Ouch! That sounds complex, so let’s define folliculitis first. Folliculitis also relates to skin conditions, specifically hair follicles inflamed by a bacterial infection.^3,9 Folliculitis itself can cause damage to hair follicles and cause permanent loss of hair. In eosinophilic folliculitis, eosinophil cells are commonly found around hair follicles where Malassezia overgrowth occurs, and some researchers state that eosinophil cells attack the sebum. Eosinophilic folliculitis symptoms on the skin show bumps and skin acne on the scalp. A diagnosis of eosinophilic folliculitis shows an increase in IgE, which is significant in allergic reactions. 

Impetigo

Impetigo is known for being a skin infection which can target the skin and scalp and it manifests in children.¹⁰ The infection reaction is stimulated by Staphylococcus, a bacterial infection. On the scalp, it is presented as a yellow/honey scab. The prevention is to improve personal hygiene.

Hair transplantation

Scabs are not always caused by a response from our immune system or a bacterial infection patients experiencing hair loss and going through hair transplantation also produce scabs to heal their scalp, in this case, scabs can even protect the scalp from bacterial infection. However, it is recommended to see the surgeon if scabs persist.

Other conditions

Children aged 3 to 13 often have head lice and we tend to check for head lice when children have itchy scalps. The nibs may be mistaken as dandruff on the hair shaft (the visible part of the hair sticking out from the skin scalp. Scabs can also be present when the scalp is infected due to scratching.

Persistent scabs seen on patients with skin cancer, like basal cell carcinoma, often indicate that patients are not recovering well enough. 

FAQs

Are scabs common?

It is normal for the scalp to renew cells every now and then. However, when the cell-division cycle in the scalp is disturbed, cells may start mass-producing themselves. Taking care of your scalp is equally important as taking care of your skin; it is recommended to keep the scalp hydrated and learn about health conditions that lead to abnormal itchiness.

While having scabs may appear embarrassing, having cells die and form scabs is a completely normal process,  it is also important to understand that even though our scalp is covered by hair follicles, scalp conditions are still classified as skin conditions. 

Can scabs be prevented?

Scabs can be prevented by improving personal hygiene; for hard water build-up effects, filtering tap water in your bathroom could be the best way to remove calcium in showerheads and reduce the risk of scabs. 

When should I call a doctor for scabs?

Consult a doctor for scabs in case it does not heal or shows signs of infection like:

• Bleeding
• Oozes pus
• Foul smell
• Discolouration

Summary

All conditions listed above show that scabs are a reaction to infection, but some scabs can also be symptoms of healing processes and protective mechanisms. We need a good understanding of scabs to avoid misdiagnoses. There is a reason why scabs appear, and they can tell more about the way we live and how we feel about it. What we need to do is self-care and raise awareness of scalp health.