What Causes Scabs on the Scalp?

Scabs on the scalp are not really any different from scabs that can appear on other parts of your body, although in some cases what causes them to appear may be something primarily associated with the scalp. While you may understandably find scabs to be somewhat annoying, and in some cases unsightly, they perform a valuable function. For that reason, you should be hesitant about attempting to remove them. It is usually better to let them leave of their own accord.

What Scabs Are and the Functions They Perform

A scab is nature’s answer to the Band-Aid. It covers and protects a wound in the skin until it has had time to heal. Most scabs are rather small, since most of them cover fairly small wounds. If your immune system is healthy, a small wound isn’t too likely to become infected, or if it should become infected, the infection tends to remain localized. You’re naturally better off not having an infection to contend with than having one, plus there’s always the chance an infection could spread. When your body forms a scab over a wound, it keeps bacteria away from the otherwise exposed tissue. The scab therefore not only allows a wound to heal but also performs a second function: it does not allow an infection to take hold and spread.

Some white blood cells, called macrophages, attack bacteria that may try to invade an open wound. Other white blood cells, called B-cells, create protein antibodies that surround the bacteria until help in the form of macrophages arrives on the scene. At the same time, a special protein called fibrin is produced, which causes platelets to begin to stick together to form a clot. Fibrin, as the name implies, is a stringy protein that will stretch across a wound and attempt to pull the edges of the wound together. If the wound is too large to be closed up tight, and most of the wounds we are able to easily see are too large, the fibrin begins to form a lid or cover over it. This cover does two things: it stops the flow of blood and seals off the wound from bacteria.

It’s not just fibrin that makes up the scab however. Some of the materials that make up a scab are casualties of the warfare between the white blood cells and invading bacteria. Along with fibrin, there will be dead bacteria (carcasses?), immune system proteins, and white blood cells.

What Happens if a Scab Is Picked at or Removed Prematurely

If you pick at or remove a scab prematurely, the process that forms it in the first place will be repeated, since by removing the scab prematurely, you have reopened the original wound. If the scab is about ready to fall off anyway, and comes off while washing or is simply brushed off, any new scab will likely be a much smaller one or a new one may not form at all.

On the other hand, if a scab is removed too soon and a new one forms, it will often be bigger than the original one. This is usually because additional tissue has been damaged. The new wound may also take longer to heal and there is always the danger of the wound becoming infected, where it may not have become infected previously. A scalp scab may not be very noticeable, especially when it is surrounded by hair, so it is less likely to be picked at. However, if it is accompanied by itching, it could easily be scratched off. If you can feel the presence of a scalp scar, you may quite naturally be tempted to remove it before it ends up in your hair resembling a huge piece of unsightly dandruff.

The most common cause of a scalp scab is scratching. There are a number of reasons why you might scratch your scalp, particularly on the top or the back of your head. You very likely do it at times without even thinking about it, and while your scratching may have nothing to do with removing any scabs, you might be unwittingly creating them. Scratching will sometimes cause the skin to break open, forming a small lesion. If this happens, the previously mentioned scab-building proteins start doing their work.

Skin ailments can also cause scabs to form, as can of course an injury to the skin that is caused by something other than scratching. The general condition of your skin can make it either more prone or less prone to forming scabs. Six of the most common causes of these scabs are described below together with several of the more unlikely but possible causes.

Common Causes of Scabs on the Scalp

1) Psoriasis

The exact cause or causes of psoriasis remain somewhat uncertain. What is known is that it is a disorder of the autoimmune system in which white blood cells cause inflammation of the skin. This inflammation will in turn cause skin cells to multiply more rapidly than normal. As a result, raised red patches appear and a scaly plaque begins to grow on the skin. While the plaque itself does not necessarily cause scabs to form, scratching at them often will do so since these scabs have a tendency to bleed if removed. Psoriasis not only is a fairly common disorder but also is considered the most common of the autoimmune diseases or disorders. Topical treatments containing aloe vera or neem oil are often effective in treating mild cases of psoriasis and will often cause the scabs to disappear more quickly since there will be less tendency to want to scratch one’s scalp. There may be times when a systemic treatment may be needed since psoriasis can also make itself known internally in the form of psoriatic arthritis. Newer medications have been developed that attack a protein that is believed to be the primary cause of the irritation that can lead to scratching and a subsequent formation of scabs. As promising as these new medications appear to be, they are known to have potentially severe side effects.

2) Eczema

Eczema is a skin disorder that can occur anywhere in the body. It most commonly occurs on the hands or elbows, but it can occur in one’s scalp as well. Since one of the more common symptoms of eczema is intense itching, scabs are often caused by scratching itchy scalp areas. Eczema, also known as atopic dermatitis, is generally considered a disease that mainly affects children and tends to be outgrown, but adults can sometimes be affected with it too. The causes of eczema are unknown so there is no known cure. There does appear to be a link between eczema, allergies, and asthma. If you should happen to develop eczema on your scalp, you need to pay particular attention to the type of soap or shampoo you’re using. A particular shampoo that triggers a reaction in one person may however not trigger one in the next person who also has the condition. Keeping your skin moisturized can help to prevent or minimize any itching in your scalp that could lead to scratching and a possible formation of scabs. Another good piece of advice is to keep your fingernails trimmed short to lessen the chance of breaking the skin should you be tempted or driven to scratch the top of your head.

3) Oily Scalp

An oily scalp is not a direct cause of scabs but it certainly can be a contributor. A fairly high percentage of those who have experienced scabbing on their scalps have oily hair. There is nothing in the oil itself that causes scabs to form. Problems nevertheless tend to arise when there is an excessive production of oil, although the usual result is simply that of having to deal with oily hair. An excess of oil can however provide the breeding ground for a fungus that is the chief cause of seborrheic dermatitis, or dandruff, as well as several other skin problems, any of which can lead to itching, scratching, and eventually formation of scabs.

4) Seborrheic Dermatitis (Dandruff

Seborrheic dermatitis and psoriasis on the scalp are often thought to be one and the same thing, but they are not. Both disorders share similar symptoms, including itching, which can lead to scratching and scab formation. Psoriasis can affect more than one part of the body, whereas seborrheic dermatitis usually only affects one’s scalp. The scales of dry skin that often form are of a silvery-white color when the condition is that of psoriasis, but they are generally a yellowish or a greasy-white color if the condition is that of dandruff. Bleeding does not usually occur when dandruff scabs are removed, and scabs are therefore less likely to form. Dandruff can itch, and sometimes severely, and scratching the itchy scalp can cause lesions in the skin, which can lead to the formation of scabs. Medicated shampoos, antifungal solutions, and corticosteroid creams are typically the treatments that are prescribed for seborrheic dermatitis.

5) Shingles

Shingles is not a particularly common occurrence on the scalp although any part of the body can be affected by this disease. Shingles is caused by the same herpes zoster virus that causes chicken pox. If shingles should appear on one’s scalp, its symptoms can be quite a bit more severe than those of other skin disorders discussed here. Besides causing an itchy rash, shingles quite often causes blisters to form. Passing a brush or a comb through your hair can easily cause some of these blisters to burst, causing scabs to form. Your scalp will also become incredibly sensitive, to the point where brushing or combing your hair could become quite an ordeal. Any scarring that forms has the tendency to destroy stem cells in the hair follicles, which can cause hair loss, and scratching those scars can make matters even worse. While scabs on your scalp caused by shingles are not something you may ever have to put up with, should it happen to you, the aftereffects could be significant in terms of potentially permanent hair loss.

6) Tinea Capitis

Tinea capitis is another scalp disorder that can potentially lead to hair loss. Like the other disorders discussed here, one of its more prevalent symptoms is itching. Tinea capitis is a fungal infection. When it occurs on one’s scalp, it is most commonly referred to as ringworm of the scalp. The fungi that can cause an outbreak of tinea capitis tend to thrive in places where the skin on one’s scalp has been injured. Even a minor skin break can serve as a home for the fungi. Hair that is infrequently washed can also create a breeding ground for the fungi, as can perspiration if the hair remains warm and wet for too long of a time. Tinea capitis is highly infectious, as is the case with ringworm in general. The symptoms consist of round, scaly patches of skin that will sometimes become inflamed. Pus-filled sores may develop in some instances. Itching is a very common symptom. Scratching at scabs that happen to develop can result in permanent scarring. Treatment is usually provided in the form of an oral medication, but the medication may need to be taken for several weeks to completely clear up the condition.

Additional Causes from Underlying Disorders or Other Sources

Most of the underlying disorders that can ultimately result in scabs forming on one’s scalp tend to be associated with the autoimmune system. Scalp problems are rarely the first symptoms to appear from one of these disorders, but may emerge eventually and should be a cause for some concern once the source has been determined. Two of the more common autoimmune diseases that can cause scalp problems are lichen planus and lupus erythematosus. The former disease can cause lichen-like scales to form across the hair follicles on one’s scalp. The latter condition causes patchy inflammation, scaling, and excessive dryness of the skin. Neither of these conditions can be self-treated. Another disease that can affect the scalp and that is thought to be possibly caused by an autoimmune disorder is alopecia areata, although the major symptom in this case is more apt to be hair loss than the presence of scabs on one’s scalp.

There are no doubt a fairly large number of potential causes of scabs on the scalp, many of which are likely quite uncommon. Three of the more common causes would be bacterial infections, head lice infestations, and severe sunburn. The first two of these three can cause itching and scratching, while scabs forming from sunburn are more likely to result from damage to the skin caused by blisters that may form and be broken.

Treating Scabs on the Scalp

Treating scabs that may have formed is not necessarily the same as treating whatever condition that has caused the scabs to form in the first place. In some instances, treating only the symptoms – the scabs – may be sufficient. At other times, the cause itself may need to be addressed. A moisturizing agent of one type or another is quite often one of the more effective methods or treatments, and one of the most effective moisturizing agents is virgin oil. The oil can simply be combed into the hair, after which the hair is covered for a few minutes and the hair is then washed with a moisturizing shampoo.

A cortisone cream will often work well. These topical creams are usually prescribed by a dermatologist and treat not only the scabs but also, in some cases, the causes behind the formation of the scabs, but normally only if those causes originate within the hair follicles. A tar shampoo, which can be purchased over the counter, is often an effective remedy.

Among the previously mentioned conditions, psoriasis and dandruff are the only two that could be considered somewhat common. For most people, an occasional scab or two may appear in their scalp from time to time, but these scabs rarely present a problem and rarely become a chronic condition. If the appearance of scabs becomes a frequent or chronic condition, the best approach to take would usually be to see a dermatologist since some of the causes will not respond to home remedies and if the scabbing is persistent, there is always the danger of infection, permanent scarring, or hair loss that have to be taken into account.

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