The short answer
Most red spots on the scalp are folliculitis, where hair follicles become inflamed or infected. Other common causes are seborrhoeic dermatitis, a reaction to a hair product, psoriasis and head lice. They’re usually harmless and settle with the right care, but spots that spread, hurt a lot, bleed or keep coming back should be checked.
What causes red spots and bumps on the scalp?
What the spots look like, and what comes with them, is the best clue. Spots on the head under the hair are easy to feel but hard to see, so ask someone to look, or take a photo.
| If you notice… | It’s most likely |
|---|---|
| Small red or white-headed bumps around the hairs, itchy or sore | Scalp folliculitis, the most common cause |
| Red, greasy, yellowish flaky patches, often along the hairline and behind the ears | Seborrhoeic dermatitis |
| Itchy redness or bumps after a new hair dye, shampoo or product | Scalp eczema or contact dermatitis |
| Raised red patches covered in thick, silvery scale | Scalp psoriasis |
| Very itchy red bites at the back of the neck and behind the ears | Head lice |
| A scaly red patch with broken hairs, usually in a child | Scalp ringworm (see a GP) |
| A tiny, smooth, bright red dot that doesn’t itch | A cherry angioma: a harmless cluster of blood vessels, common in adults |
| Pimples with whiteheads or blackheads, often near the hairline | Scalp acne |
| A painful, blistering rash on one side of the head | Shingles: see a GP the same day |
Are red spots on the scalp serious?
Usually not. Most clear up within a week or two, or settle once the cause is treated. See your GP the same day if:
- spots are spreading fast, very painful, hot or swollen, or you feel feverish or unwell
- a painful rash appears on one side of your head
- a spot or mole bleeds, grows, changes shape or doesn’t heal: the scalp gets a lot of sun
- you notice patches of hair loss where the spots were
Spots that keep coming back with patches of hair loss need checking early, as a few rare conditions, such as folliculitis decalvans, can scar the follicles and cause scarring alopecia.
What should I do about spots on my scalp?
Mild spots often settle on their own within a week or two. If they keep coming back, spread, or come with itching, flaking or hair loss, the cause needs finding first, because what helps folliculitis can make another scalp condition worse.
If something isn’t right with your hair or scalp, a consultation is where I take your history, examine your hair and scalp closely and give you a written plan.
Questions
Are spots on the scalp contagious?
Most aren’t. Bacterial folliculitis, head lice and ringworm can spread, through close contact or shared towels, combs and hats.
Why do I keep getting spots on my scalp?
Usually because the trigger is still there: a product, sweat under a hat or helmet, shaving, or a scalp condition such as seborrhoeic dermatitis that makes you scratch. Finding it stops the cycle.
Can stress cause spots on the scalp?
Stress doesn’t cause spots directly, but it can make seborrhoeic dermatitis, eczema and psoriasis flare, and it makes many people scratch more.
Do spots on the scalp cause hair loss?
Usually not. Hairs can come out where spots are inflamed or scratched, and grow back. Spots that leave smooth bald patches need checking.