- Scalp acne is caused by product buildup, not washing your hair, diet and genetics.
- It is usually addressed with medicated shampoos and topical treatments.
- More severe or cystic scalp acne can be treated with prescription medication.
- Follow good hair care habits to prevent recurring scalp acne.
Acne occurs when dead skin cells, dirt and bacteria are trapped inside your pores or hair follicles. It can appear anywhere on the body, including the scalp. Scalp acne can be treated with specific products and medications designed for use on the head. Often, it can be prevented with lifestyle changes.
Scalp Acne Symptoms
Scalp acne typically appears along the hairline in the form of small, sometimes itchy pimples. In more advanced forms, it can include papules, pustules, nodules and cysts. Severe scalp acne can form black crusts and cause permanent scarring.
Scalp acne is not to be confused with other common skin conditions on this part of the body:
Scalp folliculitis is a condition similar to acne in which bacteria cause hair follicles to become inflamed, resulting in small, itchy, red bumps.
Seborrheic dermatitis causes redness, white or yellow scaly patches and dandruff.
Pilar cysts are hard, flesh-colored bumps that grow on the surface of the skin. While they are harmless, some people have them removed for cosmetic reasons.
Does scalp acne cause hair loss?
In severe cases, scalp acne can cause hair loss and bald patches. If you experience painful, chronic acne on the scalp, consult a doctor or dermatologist to develop a treatment plan that will minimize permanent damage to your skin.
What Causes Pimples on the Scalp?
The most common reasons for acne to appear on the scalp specifically are the buildup of products such as dry shampoo, hair gel or hairspray, not washing your hair frequently enough, not washing your hair after working out and wearing headgear that rubs against your scalp.
The inflammation inside a pimple is usually caused by Propionibacterium acnes or Staphylococcus epidermidis, both being bacteria normally found on the skin. However, in the case of scalp acne, inflammation may also be caused by fungus or mites.
As with other types of acne, diet, stress levels and genetics can also contribute to pimples on the scalp.
Best Medicated Shampoos for Scalp Acne
The most common type of product to treat scalp acne is a medicated shampoo. These shampoos cleanse your hair and scalp while delivering active ingredients to eliminate the causes of frequent breakouts.
Medicated shampoos are available over the counter (OTC) at pharmacies and anywhere hair care products are sold. To effectively treat your scalp acne, follow all directions included with the product; most are designed to be used twice a week.
Medicated shampoos are formulated with active ingredients that exfoliate your scalp, reduce sebum and/or kill the bacteria or fungus that are causing flare-ups.
The most common anti-acne ingredient, salicylic acid works in several ways to treat pimples on the scalp. It is an anti-inflammatory that exfoliates dead skin cells to prevent new blemishes from forming. It also reduces oil production in the skin. Look for products containing 3% salicylic acid. Do not use more often than directed, as salicylic can dry out your hair and skin.
Glycolic acid effectively treats acne by exfoliating your skin and killing bacteria. Shampoo brands do not typically list the percentage of glycolic acid they contain, but certain brands have concentrations up to 10%.
Tea tree oil
Although typically marketed as dandruff shampoo, a shampoo with ketoconazole may help reduce acne caused by fungal infection. These shampoos are available OTC at 1% strength and at 2% or more by prescription.
Best Treatments for Persistent Scalp Acne
Chronic or recurrent scalp acne that does not respond to medicated shampoos can be treated with OTC topical treatments or, in severe cases, injections and oral medications prescribed by a doctor or dermatologist.
Over the counter topical creams
Creams, gels and serums can be used to manage scalp acne. Look for products containing anti-acne active ingredients such as salicylic acid, glycolic acid or tea tree oil.
Retinoid creams have also been proven effective at eliminating microcomedones, the precursors of other types of acne, and reducing inflammation.
To safely apply topical creams to the scalp, follow all directions included with your product.
Steroid injections or creams
Topical steroid creams may be prescribed to reduce the inflammation and swelling associated with acne. However, as these medications only address the symptoms of acne and not the cause, they should be used alongside other therapies.
For severe scalp acne, steroids can be injected directly into individual cysts to reduce pain and swelling and facilitate the healing process.
Acne in adult women is often caused by hormonal fluctuations. When this is the case, combined oral contraceptives are an effective treatment. Oral antibiotics are often temporarily prescribed in conjunction with other medications to reduce infection in the skin.
How to Prevent Scalp Acne
For some people, a few basic preventative measures are sufficient to stop scalp acne from recurring. If you continue to suffer from scalp acne, these habits can reduce the severity of the problem. They involve small lifestyle changes and careful selection of hair products.
Avoid popping pimples on the scalp
Do not pop or pick at pimples on the scalp. Your fingers can push bacteria deeper into your pores while introducing more bacteria to the area, increasing inflammation and the risk of scarring.
Use the correct shampoo
Using shampoo or conditioner designed for oily hair on a dry scalp or vice versa may disrupt sebum levels in the skin of your scalp and cause acne.
Gently wash your scalp on a regular basis with a shampoo that’s suitable for your hair and skin type to reduce the likelihood of developing pimples.
Use non-comedogenic hair products
Certain waxes, clays and hairsprays contain ingredients that are comedogenic, meaning they clog pores. Choose hair products with only non-comedogenic ingredients to prevent scalp acne due to product use.
Avoid benzoyl peroxide
Although benzoyl peroxide is commonly recommended as an acne treatment for the face, avoid using it on the scalp. It has bleaching properties that may cause unwanted lightening of your hair.
Wash bedding regularly
Launder your sheets and pillowcases once a week to prevent the buildup of dead skin cells and bacteria that can cause acne upon contact with your skin.
Scalp acne is typically caused by product buildup, poor hair care habits, genetics or diet. It can be treated with medicated shampoos or topical scalp treatments containing salicylic acid, glycolic acid or tea tree oil. Antifungal, anti-dandruff shampoos containing ketoconazole may also help reduce infection and inflammation of the scalp.
If you find that you cannot manage your scalp acne with OTC products alone, a doctor can prescribe topical or oral medications such as steroid creams, antibiotics or isotretinoin.
Prevent scalp acne by regularly washing your hair with a shampoo designed for your hair type and using non-comedogenic hair products. Do not pop or pick at scalp pimples and launder your bedding once a week to prevent the spread of acne-causing bacteria.
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