Potential causes of red spots on your scalp and how to treat them
Many scalp conditions can cause red spots on the scalp. Many of them cannot be cured, but some treatments can relieve some symptoms (such as itching). The treatment for red spots on the scalp differs depending on the underlying causes, which are described in this article.
Scalp psoriasis is a chronic (long-term) inflammatory disease that involves periods of remission (when symptoms go away) and relapse.
Half of people with psoriasis will have scalp involvement. Psoriasis is considered an autoimmune disease, which means that the immune system attacks healthy skin cells, which results in rapid cell growth.
Psoriasis tends to be inherited.
Symptoms of scalp psoriasis can include:
- Small red bumps that grow and form scales
- Thick, white or red plaques covered with silvery gray scales
- Itching (which may lead to tearing of scales and bleeding from scratching)
- Bumpy, red patches of skin with silvery scales
- Scalp lesions and dandruff-like dandruff (similar to seborrheic dermatitis)
- Significant hair loss can occur in severe types of psoriasis
The disease is considered a chronic (long-term) inflammatory disorder. It cannot be cured and involves remissions (when symptoms go away) and relapses (when symptoms return).
Scalp psoriasis is considered a difficult disease to treat.
When a person has mild scalp psoriasis, an over-the-counter medicated shampoo may be enough to help reduce symptoms. Salicylic acid shampoo works to break down scales, making them easier to remove. Prescription corticosteroid shampoo, called Clobex, may be prescribed to help reduce inflammation caused by scalp psoriasis.
Severe cases of scalp psoriasis can be treated with systemic medications, such as corticosteroids. This means that the drug is given by mouth or by injection and circulates throughout the body.
Treatment for scalp psoriasis also includes avoiding triggers such as:
- Extreme temperatures
- Certain drugs
Seborrheic dermatitis is a long-term inflammatory skin condition that is found in areas of the body that produce sebum (oil) via the sebaceous glands (sebaceous glands). The scalp is a very common area of seborrheic dermatitis because it produces a lot of sebum.
In babies, seborrheic dermatitis is called cradle cap.
Symptoms of seborrheic dermatitis can include:
- white flake on the scalp
- White flakes resembling dandruff and itching on the scalp
- Red scales on the skin
- Thick, pinkish patches on the face
- Scaly patches on the chest and hairline
- A rash made up of red spots on the scalp
- Oily yellow scales on the scalp
- Yellow crispy powdery flakes on the scalp
While there is no cure for seborrheic dermatitis, treatment modalities can help relieve symptoms such as inflammation and itching. Treatment may include:
- Over-the-counter medicated shampoo
- Antifungal drugs
- A calcineurin inhibitor (this works on the immune system to reduce inflammation of the skin)
- Corticosteroids (to reduce inflammation)
Ringworm (Tinea Capitis)
Tinea capitis – ringworm – is a type of fungal infection that commonly affects young children.
It often breaks out in schools or daycares due to close physical contact between children.
When ringworm is on the head, it is called tinea capitis; when it occurs on the skin, the name is tinea corporis.
The fungi that cause tinea capitis are very small (microscopic) plant-like organisms; they thrive in humid, warm and dark environments.
When the fungus grows on the scalp, ringworm may manifest as a small sore that looks like a pimple. Then the affected area becomes scaly, patchy, or even scaly. Flakes look the same as dandruff, but unlike dandruff, ringworm can cause hair to break, forming stubble and leaving baldness on the head.
Ringworm makes the scalp red and the affected area may be swollen and tender. Sometimes ringworm causes a pus-filled lump. Ringworm of the scalp can involve swollen lymph nodes on the back of the neck.
Antifungal sprays, creams or powders can be effective in treating ringworm minor. When the disease is more severe, a prescription may be prescribed to apply to the skin or it may be given orally (orally) to treat the fungus systemically (circulating throughout the body).
Ringworm on the scalp may require treatment for up to three months. An antifungal shampoo may be recommended by the healthcare practitioner to prevent the spread of ringworm to others.
Ringworm spreads easily
Ringworm is very contagious. It can be spread easily by sharing personal items or by touching someone with ringworm. Be sure to wash your hands before and after applying the topical medication to avoid spreading it to other parts of the body.
Folliculitis is an inflammatory disease of the skin and scalp. It affects parts of the body that have hair (and hair follicles), including the head, beard, arms, back, legs, and buttocks.
Anatomically, hair follicles are openings with very small pockets in which hair grows and sebum (oil) is produced. Folliculitis can be caused by a bacterial, fungal, or parasitic infection.
Symptoms of folliculitis, in the affected area, include:
- Reddened, painful skin
- Burning sensation
- Red spots resembling pimples (with a section of hair in the center)
- The pus may or may not be visible in the red spots
Home remedies, such as warm compresses, can often treat mild cases of folliculitis.
Systemic drugs such as oral antibiotics (taken by mouth) or antifungal drugs may be prescribed by a healthcare professional.
Acne is a common skin condition that often affects teenagers, but it can occur at any age.
It’s linked to excessive sebum production, clogged hair follicles, and hormones. It is believed that acne has a genetic link. Acne on the scalp can be influenced by:
- Blockage of follicles (by dead skin cells and sebum)
- A buildup of hair products on the scalp (especially leave-in products such as hair gel and hairspray).
Symptoms are mostly red spots (pimples) that can appear on the face, forehead, chest, upper back, and shoulders. When acne affects the scalp, it can cause symptoms such as:
- Pimples on the scalp, neck or back of the head
- Pain or itching of the affected areas
- Pimples occur in the scalp in a blocked pore or hair follicle
Acne can manifest itself in many forms, including:
- Black dots : Open, raised bumps, filled with excess oil and dead skin that appear black in the middle
- White dots: Closed raised bumps that contain sebum and dead skin and appear white on the inside
- Papules: Inflamed pink or red bumps
- Pustules: Pimples containing pus
- Nodules: Large, deep and painful pimples
Scalp acne is usually treated with medicated shampoo or scalp treatments. Shampoo helps keep sebum at bay, which can prevent acne from coming back. Some types of medicated shampoos can be purchased over the counter.
Head lice are a disease caused by living insects that are about the size of a sesame seed. They are often difficult to find, but their eggs, called nits, are usually easier to spot.
Nits come in the form of oval or round globules, stuck to strands of hair; you need a special type of comb to remove them.
Lice cause the skin to develop red bumps on the scalp, neck, and shoulders. Symptoms include:
- severe itching
- Intense scratching
- Wounds and scabs
- Possible infection (by scratching)
- Red bumps (in response to insect bites which often cause an allergic reaction)
The treatment of lice involves a very specific protocol to kill the lice and get rid of the nits, including:
- Shampoo with special medicated shampoo
- Remove nits with a special comb
- Wash items (like bed linen and clothing) in hot water to kill lice.
- Refrain from sharing personal items
- Place items that cannot be washed in a sealed plastic bag to kill lice
Keep in mind that lice are very contagious. Avoid sharing combs, hats, clothing, towels, and other personal items with anyone who has lice.
Lichen planopilaris is the name of the lichen planus that causes permanent scarring, distinct patches of hair loss, redness around the hair follicle, and inflammation of the scalp around the hair follicles affected by the disorder.
Symptoms of lichen planopilaria can include:
- Smooth white patches of hair loss on the scalp
- Lack of opening of the hair follicle in the area of hair loss
- Redness around the hair follicle at the edges that appear as red spots
- Scales surrounding the affected hair follicles on the edges of the white spots
- Hair follicles that feel prickly
- Hair that tears out easily
- Itching, pain and burning may be present (but these symptoms are often absent)
Treatment should be started as soon as possible.
Once the hair follicle has healed, nothing can be done to recover the hair that has been lost. The overall goal of treatment is to slow the progression of the disease and manage the symptoms.
Hair loss can continue even with treatment, but the goal is to slow the pace. Oral medications that have anti-inflammatory properties are given for lichen planopilaria, and these may include:
When to see a health care provider
If you are suffering from red spots on your scalp and over-the-counter medications don’t work, it’s time to see a healthcare professional.
Anytime you have symptoms of infection (perhaps scratching at itchy red dots), it is also time to see a healthcare professional.
Signs of skin infection include:
- Fluid or pus leaking from the affected area
- Sores that appear to be blisters
- Red spots with yellowish crust on top
- Pain or swelling that gets worse (even after home treatment)
- A fever