A recurring scab on the scalp in the same spot can understandably cause some concern. It can be a source of scalp discomfort, tenderness and pain and can present a risk of infection. Moreover, it may make you wonder if there is an underlying scalp condition causing it.
You will be relieved to know that in most cases, recurring scabs on your scalp in the same spot are not serious. They are likely to be the result of a common scalp problem, such as scalp psoriasis, atopic dermatitis or seborrheic dermatitis. Sometimes, the scabbing is a symptom of the condition itself, and at other times, it is a result of scratching due to the scalp itching it produces. In either case, it should heal once the main cause is treated.
However, in rare situations, a scalp scab that does not heal can be a symptom of a more severe condition. That is why it is important to see a trichologist for any persistent scalp lesions. They will be able to accurately diagnose the source of the recurring scab on your scalp and provide you with the most adequate treatment.
Keep reading to find out all you need to know about:
Scabs happen when an open lesion on your skin develops a crust as it starts to heal [1]. They can form on any part of your body, including your scalp. Under normal circumstances, once the lesion is fully healed, the scab will fall off on its own and will not reoccur in the same spot.
However, if the skin on your scalp continues to be damaged in the same area (be it by mechanical action such as scratching, or by a localised scalp condition), another lesion may form and you may get a recurring scab on your scalp in the same spot.
There are several reasons why you may get scabs on your scalp, such as injury, scalp conditions or they can even be hair transplant scabs, which are a normal part of healing from hair restoration surgery. However, usually, your scalp lesions heal and your scabs just fall off. So what can produce a recurring scab in the same spot? The most common causes for this include:
The following scalp problems can cause scabs on your scalp in two main ways – they can cause sores which then scab over or they can cause an itchy scalp which makes you scratch the already sensitive area until you draw blood, leading to crusts.
Scalp psoriasis [2]
Atopic dermatitis [3]
Topical creams or shampoos with ketoconazole, salicylic acid, zinc pyrithione or coal tar;
oral medication (itraconazole, fluconazole, terbinafine)
Ringworm [5] (tinea capitis)
Head lice [6]
Lichen planopilaris [8]
Actinic keratosis [9]
(precancerous lesions)
If you wear a hat, a helmet, headphones or another type of headgear often and for longer stretches of time, make sure you check the parts which rest against your scalp for elements that may injure it.
Rough seams, prominent tags, or hard plastic edges can cause pressure against your scalp to the point of blistering or breaking your skin. The scab thus formed is likely to recur in the same spot the next time if you wear the same headgear for long enough. Find out if headphones cause hair loss.
Dermatillomania (or skin-picking disorder) is a psychological disorder that manifests as a compulsion to pick at your skin when you are stressed, anxious or bored. This can occur on any part of your skin, including your scalp, and it can happen without you even realising you are doing it [10].
If you find a plaque, a thickened area or a scab on your scalp, you may pick at it until you draw blood, causing a new scab to form and feeding the vicious circle. This can look like you are getting a recurring scab on your scalp at the same spot, when you are actually tearing the crust off a lesion that scabs over and over again.
Dermatillomania is usually treated with cognitive behavioural psychotherapy, which can provide you with healthier mechanisms to cope with psychological stress.
Using hair products or treatments which contain harsh chemicals (hair dye, bleach, relaxant, hair acids such as glycolic acid for hair etc.) on a sensitive scalp or an area of your scalp which has been recently damaged can lead to mild chemical burns. The burned skin may scab and continuing to expose the area to the same chemicals as it is healing can lead to new lesions.
It is best to avoid using harsh chemicals when you have lesions, scabs or sores on your scalp, as they can cause further damage to your scalp. Moreover, excessive use of hair products such as bleach or dye can cause hair loss even on a healthy scalp.
A dry scalp will be flaky, rough and itchy and while it shouldn’t normally crack from the lack of moisture alone, it can make you scratch until you cause scabs. Since your scalp can be drier in some areas than others, you may be prone to scratch them more, which is likely to result in recurring scabs on your scalp in the same spot.
Moreover, a dry scalp can also cause hair loss, so it would be a good idea to keep it moisturised, in order to avoid both scabbing and hair shedding.
Several types of illness can lead to scabbing on the scalp. The varicella-zoster virus (commonly known as chicken pox), for example, is a common virus which can make itchy blisters appear all over your skin, your scalp included. As the blisters heal, they scab over. But while the itchiness can be intense, scratching off the scabs can lead to infection and scarring. And potentially, to another scab forming on your scalp in the same spot.
While chicken pox mostly affects children, the virus causing it can reactivate in adulthood, causing shingles – a rash of blisters that typically occurs on one side of your body, including your scalp. Picking at a shingles rash can prevent it from healing properly and make it seem like you keep getting a new scab in the same spot.
A rare and more serious illness that can cause scalp sores is systemic lupus erythematosus. This autoimmune condition affects mostly women (9/10 patients are female) [11] and lupus can cause hair loss in 85% of the people who experience it [12].
Symptoms of this condition can vary greatly, but the most common are fatigue, skin rashes (usually a butterfly-shaped rash on the nose and cheeks), fever, pain and joint swelling. Lupus can also cause hair loss and disc-shaped lesions or raised scaly patches on your scalp, alongside scarring, local tenderness, pain and discomfort. It is normally treated with immunosuppressants and corticosteroids (e.g. prednisone), which can make scalp symptoms improve as well.
Picking at a scab over and over is usually a sign of dermatillomania. If you find yourself constantly doing this when you are bored, anxious or stressed, it is a good idea to see a cognitive behavioural therapy specialist to help you overcome this habit [10]. Allowing this compulsion to continue carries complication risks, such as:
If you have a scab on your scalp which does not seem to heal in a few days, it is important that you see a dermatologist or trichologist as soon as possible. In rare cases, persistent lesions or growths on your scalp that do not heal can be a symptom of scalp cancer. 14-49% of melanomas (skin cancer) occur on the scalp [13] and other forms of cancer can affect your scalp, such as squamous cell carcinoma [14].
While these conditions generally have a good survival rate if diagnosed in the early stages [13][14], diagnosis is often delayed because scalp lesions are less visible than those on the face and more likely to be ignored [15].
The treatment for any recurring scabs on your scalp depends on the reason why they developed. Many of the scalp conditions which cause scabbing require medication which can have unwanted side effects or interactions with other treatments. That is why it is a good idea to avoid self-medication and follow the recommendations of a trichologist.
However, if you are looking for home remedies to help heal the recurring scabs on your scalp, you can try the following:
While they may feel unpleasant to the touch, scabs on your scalp are not a problem in themselves, they are a sign your skin is trying to heal. What you really want to prevent is the occurrence of lesions on your scalp, which will eventually scab over. Lesions pose a greater risk than scabs, because, being open wounds, they can allow harmful germs to enter your body.
Here are the best things you can do to keep your scalp healthy and lesion-free:
Yes, recurring scabs on your scalp can cause hair loss if scarring develops, as the permanently damaged hair follicles in the scarred area will stop producing new hair. Infection can increase the risk of scarring, as it prolongs the amount of time the skin is damaged. To avoid scarring and infection, avoid picking at scabs or detaching the crusts before they fall off on their own.
Moreover, some of the conditions that can cause recurring scabs on your scalp, such as yeast infections on the scalp or even an excessively dry scalp, can cause diffuse hair thinning all over your scalp, not only at the scabbing site.
Finally, if you have health anxiety, constant worrying about the recurring scab on your scalp can cause stress. And stress itself can lead to temporary diffuse hair loss, known as telogen effluvium.
If you are concerned about hair loss associated with the recurring scab on your scalp, the best thing to do is to book a consultation with one of our top trichologists. They will provide a thorough examination of your scalp and may perform a dermoscopy or a skin biopsy to identify what causes your scabbing and whether it is connected to your hair loss, or if your hair shedding has different causes, such as androgenetic alopecia, telogen effluvium, alopecia areata or traction alopecia.
If the recurring scab at the same spot on your scalp and your hair loss is caused by a scalp condition, the doctor will recommend the most efficient treatment, which will likely help them both.
However, if your hair falling out is the result of an unrelated type of alopecia, you may receive one of the following scientifically recognised hair loss treatment recommendations:
Seeing a scalp and hair professional will not only get you the recommendations and treatment you need to ensure that the scab on your scalp heals properly and does not return. It will also bring you peace of mind that your condition is benign, or – in the worst-case scenario – give you a timely diagnosis. So it remains the safest course of action for a happy, healthy scalp and hair.
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