Scalp pimples are very common, but making a few changes to your hair routine can usually clear them up.
What Causes Scalp Pimples?
Scalp acne is when pimples and breakouts happen on your scalp or hairline. Acne can be a complex skin condition, but it generally happens because of four processes:
- An increase in sebum, or oil, production
- A buildup of dead skin cells and dirt in your hair follicles
- Inflammation in the blocked hair follicle
- An increase in acne bacteria
Your scalp is full of hair follicles and oil glands. If the follicle or pore becomes clogged with dirt and oil, this can lead to acne. You can still get scalp acne even if you have good hygiene, but sweat, oil, and dirt buildup from improper washing can lead to clogged pores.
However, you may need to reexamine your hair care routine. Lots of scalp pimples are caused by shampoos, styling gels, and hairsprays that leave residues on your scalp and clog your pores.
Scalp acne caused by hair products is so common that it has its own medical name: acne cosmetica.
Hormones can also cause acne. Androgen hormones, especially testosterone, cause your body to make more oil. The increase of hormones during puberty is often responsible for acne, but adults can have hormonal acne too.
Genetics also affects your skin. If you have an immediate family member who has acne, you're more likely to have it too.
What Are the Types of Scalp Acne?
Acne is usually graded by severity and by the type of pimples you have, which might affect your treatment.
Types of acne severity include:
- Mild
- Moderate
- Severe
Types of pimples include:
- Blackheads, called open comedones
- Whiteheads, called closed comedones
- Papules, or inflamed bumps
- Pustules, or bumps filled with pus
- Nodules or cysts, which are painful pimples deep in your skin
- Mixed, which is a combination of types
Sometimes, you can get severe forms of acne, such as acne conglobata and acne fulminans, which can affect your scalp. These are very uncommon.
What Are the Symptoms of Scalp Acne?
Scalp acne can appear throughout your hair or along your hairline. Common symptoms include:
- Tiny bumps along your forehead or the back of your neck
- Tiny bumps you can feel but can’t see
- Tiny bumps packed together that you can see
- Whiteheads on your scalp or hairline
- Flesh-colored bumps on your scalp or hairline
- Painful bumps on your scalp
- Deep cysts under your skin with no head
- Itchiness
Sometimes acne affects your emotions and self-esteem. It’s common for people to feel embarrassed and even depressed because of acne.
How to Treat Scalp Acne
If your scalp acne is caused by your shampoo or other cosmetics, it will go away on its own when you stop using them. It can take up to six weeks to see improvement, but the first thing to do is to change your hair routine and products.
Switch to shampoo, conditioner, hair spray, and products that don’t contain oil. The label should say things such as:
- Oil free
- Noncomedogenic
- Antiacnegenic
- Won’t clog pores
Keeping the dirt, oil, and sweat off your scalp will help keep your pores clean. You might need to wash your hair more often, especially if you:
- Have oily hair
- Use a lot of products in your hair
- Sweat a lot in the day
- Have dirt or grime in your hair from the day
To wash your hair, focus on the scalp. The hair on your head is dead, and while your hair products can help keep your hair shiny and healthy, it’s actually more important to wash dirt and oil from your scalp.
It’s also important to make sure you fully rinse all the extra shampoo and conditioner off your scalp and face. The pimples along your hairline might be caused by buildup from not rinsing properly.
The product residue can also transfer to whatever touches your hair, which can add to the problem. Make sure to wash everything that touches your head, including:
- Pillowcases
- Hats
- Visors
- Headscarfs
- Headbands
- Bedsheets
- Blankets
Scalp acne shampoo
If thorough rinsing doesn’t help, you may be able to manage scalp acne by changing to products that are oil-free and antibacterial. Also look for:
- An anti-dandruff shampoo that contains selenium sulfide, tar, or zinc pyrithione
- An antifungal shampoo that contains ciclopirox or ketoconazole
- Shampoos or washes that contain benzoyl peroxide
- Salicylic acid shampoos
- Sulfur shampoos
Other treatments for scalp acne
If topical remedies don’t ease your scalp acne symptoms, you might need other treatments, such as:
- Antibiotics
- Photodynamic therapy
- Drainage for complicated cystic scalp acne
- Steroid injections directly into cysts
What Is the Outlook for Scalp Acne?
Lots of times, scalp pimples result from shampoo or other products. Just changing your hair routine can get rid of the problem without any other treatment. Other times, scalp acne is a bit more complicated and needs other treatment. The outlook for scalp acne is good, but if it doesn’t get better with some of these changes, talk to your doctor.
Scalp Acne vs. Folliculitis Decalvans
A condition that can look similar to scalp acne is folliculitis decalvans. It’s a rare form of alopecia or hair loss. Scientists aren’t sure exactly what causes it, but they think it may be an abnormal response by the body to the bacterium Staphylococcus aureus.
Folliculitis decalvans usually begins in adulthood. The primary symptoms are patchy hair loss with inflammation and pimple-like sores around the area where hair falls out. It usually affects the skin on your scalp, most often on the back of the head. You’ll notice irritated spots with sores or pimple-like bumps on them. You may have discomfort in the affected areas. The affected hair will fall out, leaving round or oval-shaped bald patches.
Major symptoms of folliculitis decalvans include:
- Patches of hair loss
- Clusters of pustules around bald patches
- Several hairs growing out of a single follicle, causing a tufted appearance like the bristles on a toothbrush
- Redness or swelling of the scalp
There is no cure for folliculitis decalvans, but some treatments can ease symptoms. They may include:
- Oral antibiotics to clear up any sores or pustules on your scalp
- Topical antibiotics that can reduce the presence of Staphylococcus aureus
- Isotretinoin to treat pustules
- Oral or topical corticosteroids to ease inflammation, pain, and itching
- Photodynamic therapy to lessen the severity of symptoms
Takeaways
Scalp pimples can be clogged by dirt, oil, sweat, or leftover hair products.
You can prevent getting them by washing your hair and scalp with a shampoo that is noncomedogenic (meaning it won’t clog pores) and oil-free. Make sure to wash out any shampoo residue thoroughly, as it can cause buildup.
If your scalp acne doesn’t improve, see your dermatologist, as it could be a more serious issue.
Scalp Acne FAQs
When should I see a dermatologist for scalp acne?
You should go see a dermatologist if over-the-counter meds aren’t working, or if you have any pain, increased redness, fever, or chills.
What vitamin deficiency causes scalp acne?
Check with your dermatologist if you think you have a vitamin deficiency. If you are eating a balanced diet, you may not need any vitamins. In fact, the foods you eat may already contain the vitamins you need for healthy skin.
Are there long-term side effects of scalp acne?
Yes. You may have an infection, permanent scarring, hair loss, or develop lighter (hypopigmentation) or darker (hyperpigmentation) areas on your scalp if your acne is severe.
