Erosive Pustular Dermatosis of the Scalp: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor treats Erosive Pustular Dermatosis of the Scalp?
A dermatologist usually treats this rare condition, which can be hard to tell apart from infections, skin cancer, and other scalp diseases. A primary care doctor can make a referral. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is erosive pustular dermatosis of the scalp?
Erosive pustular dermatosis of the scalp is a rare skin problem. It causes open sores, bumps filled with pus, and crusting on the head. It mostly affects older people, especially women. It is not an infection, and it is not contagious. That means it cannot spread from person to person.
It causes raw, weeping patches that heal slowly and often come back. "Erosive" means the skin wears away into open sores; "pustular" means small pus-filled bumps appear, caused here by inflammation rather than infection. The sores can damage hair follicles, causing permanent hair loss.
Symptoms
Common symptoms include:
- Open sores that ooze fluid and form yellow crusts.
- Small pus-filled bumps on red skin.
- Raw or worn-away patches.
- Slow healing over weeks or months.
- Itching, burning, or tenderness.
- Hair loss where sores return.
Causes and who gets it
Doctors do not fully understand the cause, which seems to involve inflammation rather than infection. Risk factors include scalp injury, certain scalp treatments, and sun damage. It is most common in people over 70 and in women.
How doctors diagnose it
There is no single test. A dermatologist usually diagnoses it by examining the scalp and medical history. Because other conditions can look similar, the doctor may do a biopsy to rule out infections and skin cancer.
Treatment
The main goal is to calm the inflammation so the sores can heal. Doctors often prescribe strong corticosteroid medicines, applied to the scalp or taken by mouth, and some people need long-term treatment to prevent flare-ups.
When to see a doctor
See a doctor if scalp sores do not heal within a couple of weeks, keep coming back, or cause hair loss. Any sore that bleeds, grows, or changes should be checked, since skin cancer can look like a sore that will not heal.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Because this condition is rare and can mimic serious diseases, these doctors would typically refer the patient to a dermatologist.
Common questions
Is erosive pustular dermatosis of the scalp contagious?
No. It cannot be passed to other people through touch, sharing hats, or anything else. It is caused by inflammation in the person's own skin, not by germs that spread.
Will my hair grow back?
Hair often grows back if the sores are treated before scarring develops. If the skin has scarred, the hair loss in those spots is usually permanent. Results differ from person to person. Early treatment gives the best chance of keeping hair.
Is it skin cancer?
No, this condition is not cancer. However, some skin cancers can look like open sores on the scalp. This is why doctors often do a biopsy to be sure of the diagnosis.
Can it come back after treatment?
Yes, flare-ups are common. Many people need ongoing or repeated treatment to keep the skin clear. Regular follow-up with a doctor helps catch new sores early.
Sources
- NIH Genetic and Rare Diseases Information Center - Diseases
- MedlinePlus - Skin Conditions
- American Academy of Dermatology - Skin Conditions
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
