Small red painful bumps over the scalp at the base of the hair are not uncommon. This occurs in children and adults as well. It commonly occurs due to inflammation of hair follicles, due to infection. A hair follicle is a strand of hair; hair strands are different from the hair root, which is part of the hair below the scalp. Infection can be bacterial, viral, fungal, or even parasitic. Secondary bacterial infections can arise from scratching itchy, fungus- or microbe-infected hair follicles. Dust and microbes present in nail beds can cause abrasion due to scratching, and lead to infection. Allergic reactions to something applied or used over the scalp can also cause itching and secondary infection resulting in boils. Sebaceous cysts, i.e. inflammation of the sebaceous (oil-producing glands) can also produce boils. These boils produce small red, inflamed itchy, and or painful bumps which may be filled with pus. In some cases, crusty sores may be formed. Rarely, fever may occur if boils are extensive. Epidermoid cysts, also known as epidermal inclusion cysts, are benign keratin-filled bumps, that develop under the skin and are commonly present on the face, neck, scalp, and trunk. Pilar cysts are common benign cysts filled with keratin. They are mostly formed from hair follicles and are painless. But if they get infected, can result in boils. Hair salons can be a source of infection, due to the use of common, contaminated tools from one client to another. Sharing combs, and towels, between individuals is yet another cause of boils. Use of haircare products that irritate the skin of the scalp, can result in boils due to secondary infection of the denuded skin. It can occur in any age or either gender. People with reduced immunity like those with uncontrolled diabetes, very young or old people, and those with anaemia, cancer, etc. are more prone to develop boils over the scalp and it may occur in severe form. Boils should not be ignored. There is a risk of recurrent infection or it spreading to the brain, via the bloodstream, due to close vicinity. The microbes can reach the underlying bone, infecting it or even the heart. It can spread to the body through the bloodstream, causing sepsis. Boils can occur in other parts of the body as well. It can result in scarring and discolouration of the skin. Disruption of hair follicles can occur, resulting in hair loss. Diagnosis is easy due to the typical clinical presentation. Using a warm moist, cloth several times over the scalp per day, helps in checking infection. The use of medicated hair shampoos for washing the hair helps control it and its spread. Local application of antibiotic ointment is sometimes not very effective, due to the presence of hair follicles. In such a situation, the use of a suitable antibiotic by mouth for three to five days helps in controlling the infection. Itching can be controlled by some anti-allergy tablet or soothing cream that causes a soothing effect. If the above measures do not help, pus from a boil can help to identify the causative germ and suitable antibiotic to cure it. A scraping from the boil can help to confirm fungal infection, after examination under the microscope. Prevention lies in avoiding shared towels over the scalp. When in a hair salon, a person should ensure that the scissors, razors, etc. tools used are cleaned after use on another client. Washing hair regularly, particularly after exposure to dust or becoming sweaty, helps prevent any infection. A diet rich in proteins and anti-oxidants is helpful to maintain immunity and boost it, thus preventing infections. Dr Rachna Pande is a specialist in internal medicine.