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Scalp Abscess - Causes, Diagnosis, and Treatment

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A skin scalp abscess is a tender mass surrounded by red or pink skin. Read below to learn more.

Medically reviewed by

Dr. V. Srikanth Reddy

Published At September 5, 2022
Reviewed AtJanuary 9, 2024


A scalp infection is mainly the reason for a scalp abscess caused by bacteria and fungi entering the scalp's hair follicles or skin. Infections cause the vast majority of them. These bumps are full of pus, bacteria, and debris. Having a scalp infection can lead to skin rashes on the scalp and hair loss.

What Are the Types of Infection That Can Cause Scalp Abscesses?

  • Folliculitis: Folliculitis is an infection that causes hair follicles to become inflamed and swollen, bacteria most commonly cause it. Scalp folliculitis causes small, itchy bumps to form on the scalp, often most troublesome on the frontal hairline. Treatment includes topical antiseptics such as Benzoyl peroxide, topical and oral antibiotics, topical steroid creams, and oral antihistamines.

  • Fungal Infections: Infections like candida cause the condition. Some symptoms include crust on the scalp, purple or red patches of skin, and skin filled with pus due to the infection. Treatments can be antifungals, corticosteroid shampoo, or over-the-counter medications.

  • Impetigo: An infectious skin infection caused by Streptococcus (group A strep) and Staphylococcus aureus, also known as staph. Red and itchy sores can break, causing the release of pus or clear fluid and scabbing of the sores. Treatments include antibiotics, both oral and topical. The wounds on the scalp should be kept covered to avoid spreading infection.

  • Lichen Planus: Lichen planus causes swelling and discomfort on the skin. It is an autoimmune disease. And it affects hair follicles. It is referred to as lichen planopilaris when it develops on the scalp. Some symptoms include scaly skin on the scalp and around the hair follicles, redness, and bald patches, which cause hair loss, pain, burning, and itchiness. Treatment options include immunosuppressive medications, topical steroids, antibiotics, and antifungals.

  • Seborrheic Dermatitis: Seborrheic dermatitis causes scaly patches and gives red skin. Inflammatory reactions in the body and a family history of the conditions are unknown. Treatment includes antifungal shampoo and topical steroids.

What Is Kerion?

  • An inflammatory, pus-filled sore (abscess) that occasionally leaks is called a kerion (keer-ee-on). When the immune system overreacts to the fungus that causes ringworm, or tinea corporis, kerion in children occurs. Although the scalp is where they most frequently appear, they can also appear on the face, neck, shoulders, and upper arms.

  • A big pus-filled sore brought on by a fungal infection is called a kerion. It typically shows up on the scalp. It could feel soft to the touch, exude pus, have a yellow or crusty appearance, and result in hair loss. The fungal infection is treated with oral antifungal drugs.

  • Anyone can be impacted by kerion fungal infection. Nonetheless, youngsters are typically impacted by them.

  • Large, thick, swelling, inflammatory abscesses are called kerions. If left untreated, kerions can result in permanent hair loss (alopecia) and scarring.

  • Kerions may cause one to become self-conscious about appearance. They may also have an impact on conduct and self-perception. One can feel stressed, anxious, or depressed. The patient might also start to feel self-conscious.

  • Causes:

    • Microsporum canis.

    • Trichophyton mentagrophytes.

    • Trichophyton tonsurans.

    • Trichophyton verrucosum.

  • Symptoms:

    • A big, dense, pus-filled pustule.

    • Feels mushy or muddy to the touch.

    • Gushing pus out of hair follicles.

    • Growing.

    • Inflammation.

    • Burning sensation.

    • A broken hairline.

    • Hair fall.

    • High temperature.

    • Enlarged lymph nodes in the throat.

  • Treatment:

  • Prevention:

    • Steer clear of sharing personal accessories and headgear, such as hats, pillows, combs, brushes, and sports helmets.

    • Maintain a dry and clean scalp.

    • Regularly wash pillows, sheets, and other bedding.

    • Wash hands after touching or interacting with animals, such as dogs and cats.

What Happens in a Scalp Abscess in Children?

  • Neonatal sepsis linked to maternal microbes has the potential to be fatal. Low gestational age, inhaled amniotic fluid, and intrapartum fever are among the hazards of newborn infection. It is frequently used in clinical practice to find newborn scalp masses. An abscess is uncommon to form after a scalp hematoma infection. An abscess requires both anti-infection medication and surgery.

  • Causes:

    • Escherichia coli is the most prevalent bacterium responsible for newborn sepsis and can spread to the brain, soft tissue, blood, and bones.

    • The most common causes of scalp hematomas (a collection of blood outside the blood vessels on the scalp) include blunt instrument injuries, early deliveries, primigravida deliveries (first-time pregnancies resulting in childbirth), and midwife errors. A tractive fetus (a fetus experiencing traction or pulling forces during delivery) and birth canal compression are common causes of cephalohematoma (a collection of blood between the skull and the periosteum (membrane covering the bones) of a newborn's head, often caused by trauma during delivery).

    • Fetal monitoring, scalp trauma, and direct hematogenous seeding are the factors that affect infection.

  • Treatment:

    • A scalp hematoma usually heals independently, although larger hematomas may need to be removed through puncture and compressed with bandages.

    • A few hematomas must be sliced open to extract the hematoma and stop the flow of any fluids. The complications of a neonatal scalp hematoma can include infection, hypovolemic shock (a medical emergency marked by a significant decrease in blood volume), anemia (decreased red blood cells or reduced hemoglobin), and other issues.

How Does an Abscess Form Due to an Infection or Irritant?

Bacteria can enter the skin when our normal skin barrier is broken, even from minor trauma, small tears, or inflammation. An abscess can form as the body's defenses try to kill these germs with an inflammatory response. Obstruction in a sweat or oil (sebaceous) gland, a hair follicle, or a pre-existing cyst can also trigger an abscess. The middle of the bump liquefies, and it contains dead cells. This area grows and creates tension under the skin and further inflammation of the surrounding tissues pressure and inflammation cause the pain.

What Can Be the Symptoms of Scalp Abscess?

  • A painful, compressible mass that is red and tender.

  • An abscess progresses. It can rupture eventually.

  • Most abscesses start growing, so the infection can spread to deeper tissues and into the bloodstream.

  • If the infection spreads, the patient can have a fever, nausea, vomiting, increasing pain, and increasing skin redness.

When Should One Consult a Doctor?

A scalp abscess will sometimes rupture and drain. A ruptured abscess will release the pus, giving the body a better chance of healing. One should visit a doctor if they have any of the following:

  • The sore is more significant than one centimeter.

  • The sore does not heal, or it continues to enlarge.

  • If the bump is painful.

Who Should Be Cautious About This Condition?

  • HIV or AIDS, cancer, diabetes, sickle cell disease, or peripheral vascular disease.

  • The person who is a drug abuser.

  • An individual is on steroid therapy, chemotherapy, other drugs that suppress the immune system, or dialysis.

  • The person who has a fever.

  • If the foreign material exists inside a wound or under the skin.

  • If the person is pregnant.

  • If there is a recurrence of the abscess.

When Should One Seek Immediate Attention?

  • Fever or vomiting, especially if the person is on steroids, chemotherapy, or other immunosuppressive medications.

  • If there is a spreading red streak on the skin originating from the abscess.

  • Any abscess more significant than one centimeter or half an inch across.

What Are the Treatment Options for Scalp Abscesses?

Home remedies can help relieve symptoms for some conditions: Over-the-counter anti-itch creams or a cold compress can help with the itching and pain. One should visit a primary care physician or dermatologist if the symptoms worsen.


Abscess drainage is usually safe and effective. If the size and area are painful, one should immediately meet a doctor to ease the discomfort. An individual should maintain good personal hygiene by washing the skin with soap and water regularly to avoid such bumps and avoid cutting oneself when shaving the underarms or pubic area.

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Dr. V. Srikanth Reddy
Dr. V. Srikanth Reddy



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