Acne is less common on the scalp than on other areas of the body. However, it can be just as troublesome.
Clogged pores often cause pimples on the scalp or scalp acne. Keeping the hair and scalp clean and using medicated shampoos can help treat the condition.
This article looks at how a person can identify scalp acne, what causes scalp acne to develop, and discusses the ways a person can treat and prevent this condition.
What is scalp acne?
Scalp acne refers to the pimples and breakouts that develop on the scalp or hairline.
Scalp acne can develop when hair follicles become clogged by a buildup of dead skin cells or excess sebum, which can lead to inflammation in the hair follicle. Sebum is the natural oil produced by sebaceous glands to form a protective barrier on the skin.
A person’s pores can also get clogged if they do not wash their hair frequently or they regularly wear headgear that causes friction against the scalp.
The American Academy of Dermatology Association (AAD) notes that some people may develop bumps or pimples on their scalp when using certain shampoos, conditioners, or hairsprays.
This particular type of breakout is called acne cosmetica, which refers to scalp acne that develops upon using products that come into contact with the hair or skin.
Furthermore, organisms that can lead to inflammation include:
- fungus
- mites
- Staphylococcus epidermidis
- Propionibacterium acnes
Treatment for scalp acne
A person may need a topical, medicated treatment for their scalp acne.
Medicated topical products for scalp acne can be bought without a prescription. Common ingredients in these products may include:
- Salicylic acid: This is a common ingredient used in skin care products to fight acne. Salicylic acid helps to clear dead skin cells by breaking down the bonds between them.
- Glycolic acid: This acid can help exfoliate the scalp and remove dead skin cells, bacteria, and sebum.
- Ketoconazole: An antifungal agent, ketoconazole is used to treat red or scaly skin.
- Ciclopirox: Ciclopirox is an antifungal agent used to treat skin infections and is often added to dandruff shampoos
- Benzoyl peroxide: An antibacterial ingredient, benzoyl peroxide helps to eliminate the bacteria Propionibacterium acnes, which can be present in scalp acne.
For persistent scalp acne and symptoms such as hair loss and inflammation, a person can consider discussing the following treatments with a doctor:
- topical antibiotic ointments
- steroid injections
- oral antibiotics
- antihistamines for allergic reactions
- phototherapy, also called light therapy
- specific medications for severe acne, such as isotretinoin
A person with scalp acne should only use one type of scalp treatment at a time unless otherwise directed by a doctor. In doing this, it will be easier for a person to track the effectiveness of individual products against their scalp acne.
What causes scalp acne?
Scalp acne can vary in its appearance. Sometimes, scalp acne can resemble small pimples or zits on the scalp. These spots can develop on the back of the head and may feel itchy and sore.
In other cases, a person may develop pimples along their hairline or have painful bumps or cysts under the skin.
Pimples on the scalp occur when a pore or hair follicle gets clogged with dead skin cells or sebum.
Bacteria, yeast, or mites can also get into the pores and cause a reaction.
Factors that can cause scalp acne include:
- dead skin cells or oil clogging the follicles
- a buildup of products, such as hair gels, leave-in treatments, or hairspray
- not washing the hair thoroughly enough
- waiting too long after a workout to wash the hair
- sweating while wearing a head covering, especially if it causes friction
Specific germs that may cause pimples on the scalp include:
- Yeasts from the Malassezia family
- Cutibacterium
- Staphylococcus epidermidis
- Propionibacterium acnes
- Staphylococcus aureus
- Demodex folliculorum
A person’s diet may also be linked to acne. A study published in Advances in Dermatology and Allergology suggests that a diet high in sugary carbohydrates may increase the risk of acne.
Symptoms of scalp acne
The AAD states that people with scalp acne may notice that they have:
- tiny bumps along the hairline, on the forehead, or at the back of the neck
- whiteheads on the scalp or hairline
- closely packed bumps
- bumps on the scalp that are painful
Some people may also develop bumps that they can feel but are unable to see.
Preventing scalp acne
Scalp hygiene plays an essential role in avoiding clogged pores. A person can try washing their hair whenever it starts to feel oily and after every workout.
To treat scalp acne and prevent further flare-ups, a person can consider:
- wearing looser-fitting headgear to let the scalp breathe
- washing hair soon after exercise
- avoiding using too many hair products, such as hairsprays and gels
- eating a diet that can help boost skin health
- keeping a food diary to see if certain foods cause flare-ups if a person thinks their diet may be causing scalp acne
- switching to natural, hypoallergenic hair care products.
For some people, washing their hair infrequently can cause scalp acne. For other people, washing their hair too often can strip the skin of protective sebum, which may increase the risk of scalp irritation.
A person may wish to speak with a dermatologist to find out the best hair care routine for their skin.
Types of scalp acne
People can develop pimples on the scalp, which, according to a 2019 article, can be:
- Mild: This usually includes whiteheads and blackheads, which are clogged pores in the skin.
- Moderate: Individuals with moderate scalp acne may have a higher number of inflamed pimples, called papules, that are visible on the skin’s surface. A person may also have pustules, which are filled with pus.
- Severe: A person with severe acne will have more papules and pustules, and the scalp can develop nodules and cysts, which can be painful.
There are a number of reasons why bumps and pimples might appear on the scalp, which can make it more difficult to identify scalp acne. These reasons can include:
- Scalp folliculitis: Scalp folliculitis is a related condition where bacteria, yeast infections, or ingrown hairs on the scalp cause the hair follicles to become infected and inflamed. This can result in itchy red bumps that can vary in size.
- Seborrheic dermatitis: Seborrheic dermatitis is a common condition that causes dandruff and often leaves the scalp red and scaly. Picking at the area can cause additional injury, leading to marks that resemble pimples.
- Pilar cysts: Pilar cysts are hard bumps filled with keratin that form near the hair root. Unlike scalp acne, these bumps usually do not have a white head.
In other cases, bumps on the scalp may be a sign of cancerous cells, such as squamous cell carcinoma.
When to see a doctor
A person should consider seeing a doctor if they think they have pimples on their scalp. A person may also consider seeking medical advice if they notice any signs of infection in any of their scalp pimples, such as pain, inflammation, or pus.
A person may wish to make a note of any hair products they are using in case they might be the cause of their scalp acne.
The AAD states that when a person’s scalp acne is caused by skin or hair care products, the scalp acne can go away on its own after the individual stops using the products.
Summary
Pimples on the scalp are relatively common and are treated in a similar way to acne on other parts of the body.
When treating scalp acne, a dermatologist will often recommend topical medications, which may include daily medicated shampoos.
A person can try taking preventive measures to improve their scalp acne, such as changing their hair care products or increasing or decreasing the amount they wash their hair overall.
Scalp acne may sometimes be a sign of more serious conditions. If a person finds their scalp acne is not responding to treatment, they may wish to consult with a doctor to seek other treatments or diagnoses.
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