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What to Know About Scalp Acne

Medically Reviewed by Dan Brennan, MD on June 13, 2021

Scalp pimples are very common, but making a few adjustments to your hair routine can usually clear it 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:

  1. An increase of sebum, or oil, production
  2. A buildup of dead skin cells and dirt in your hair follicle
  3. Inflammation in the blocked hair follicle
  4. 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 or incomplete washing can lead to clogged pores.

However, you may need to reexamine your hair care routine. Lots of scalp pimples are caused by shampoo, styling gel, and hairsprays that leave residues on your scalp and also 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 will affect your skin. If you have an immediate family member who has acne, you’re more likely to have it too.

Types of Scalp Acne

Acne is usually graded by severity and by the type of pimples you have, which might change your treatment. ‌

Types of acne severity include:

  • Mild
  • Moderate
  • Severe‌

Types of pimples include:

  • Blackheads, called open comedones
  • Whitehead, called closed comedones
  • Papules, or inflamed bumps
  • Pustules, or bumps filled with pus
  • Nodules or cysts, or painful pimples deep in your skin
  • Mixed, which is a combination of different types

Sometimes you can get severe forms of acne that can affect your scalp called acne conglobata and acne fulminans. These are very uncommon though.

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

Acne doesn’t usually cause an itchy scalp and this symptom could be a sign of other skin problems like psoriasis.‌

Sometimes acne affects your emotions and self-esteem. It’s common for people to feel embarrassed and even depressed because of acne. 

Treatment for Scalp Pimples

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 6 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 like:

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-looking, 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 improper rinsing.‌

The product residues can also transfer to whatever touches your hair, which can add to the problem. Make sure to wash everything that touches your head, including:

  • Pillow cases
  • Hats
  • Visors
  • Headscarfs
  • Headbands
  • Bedsheets
  • Blankets‌

If your scalp acne is not caused by your products, you might need other treatments. These can include:

Outlook for Scalp Acne

Lots of times scalp pimples are from shampoo or other products. Just making a switch to 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.

WebMD Medical Reference

Sources

SOURCES:

American Academy of Dermatology Association: “10 reasons your scalp itches and how to get relief,” “Acne: Overview,” “Are your hair care products causing breakouts?” “Tips for healthy hair,” “What kids should know about taking care of your hair.”

American Family Physician: “Diagnosis and Treatment of Acne.”

Indian Journal of Dermatology: “Shampoo and Conditioners: What a Dermatologist Should Know?”

International Journal of Trichology: “Acne Conglobata of the Scalp.”

Medscape: “Acne Fulminans.”

Molecules: “Treatment Modalities for Acne.”

Photodiagnosis and Photodynamic Therapy: “Combination of surgery and photodynamic therapy for the treatment of cystic acne of the scalp.”

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