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Acne is less common on the scalp than on other areas of the body, but it can be just as troublesome.

Clogged pores often cause pimples on the scalp, or scalp acne. Keeping the hair clean and using medicated shampoos can help treat the condition.

In this article, we look at how to identify scalp acne, its causes, and ways to treat and prevent this condition.

Woman having scalp inspected for scalp acne by dermatologistShare on Pinterest
Scalp acne may be treated with medicated shampoos or ointments.

In most cases, a doctor will recommend a medicated shampoo or scalp treatment. These shampoos can wash away any excess oil and debris and prevent scalp acne from returning.

Medicated shampoos for scalp acne can be bought online without a prescription. Common ingredients in these products include:

  • tea tree oil, an essential oil that may help eliminate bacteria on the scalp
  • salicylic acid, which helps to get rid of dead skin cells
  • glycolic acid, which can help exfoliate the scalp, removing dead skin cells, bacteria, and sebum
  • ketoconazole, an antifungal agent that may improve scaly or red skin
  • ciclopirox, an antifungal used to treat skin infections that is often added to dandruff shampoos
  • benzoyl peroxide, which helps eliminate the bacteria Propionibacterium acnes, which can be present in severe scalp acne

For persistent scalp acne and associated symptoms, such as hair loss and inflammation, a doctor may prescribe the following treatments:

  • topical antibiotic ointments or steroid creams
  • 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. This way it is easier to track the effectiveness of individual products.

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Folliclitis is a similar condition to acne, caused by bacteria infected hair follicles.
Image credit: Lforlav, (2011, 29 June.)

Scalp acne looks like small pimples or zits on the scalp, including the back of the head. These pimples can be itchy and sore.

Just like pimples elsewhere, pimples on the scalp occur when a pore or hair follicle gets clogged with dead skin cells or sebum, which is the natural oil the skin uses to keep itself moisturized.

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 be causing severe scalp acne include:

  • Yeasts from the Malassezia family
  • Cutibacterium
  • Staphylococcus epidermidids
  • Propionibacterium acnes
  • Staphylococcus aureus
  • Demodex folliculorum

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.

Scalp hygiene plays an essential role in avoiding clogged pores. A good rule of thumb is to wash the hair whenever it starts to feel oily and after every workout.

To treat scalp acne and prevent further flare-ups, try:

  • wearing looser-fitting headgear to let the scalp breathe
  • washing hair soon after exercise
  • switching to natural, hypoallergenic hair care products. A range of products is available for purchase online.
  • avoiding using too many hair products, such as hairsprays and gels
  • getting enough vitamin A, D, and E, to keep the skin healthy. Multivitamin supplements are available for purchase in health food stores and online.
  • keeping a food diary to see if certain foods cause flare-ups if diet is a suspected cause

For some people, infrequent hair washing can cause scalp acne. For other people, washing the hair too often can strip the skin of protective sebum, which can increase the risk of other contaminants getting in. Speak to a dermatologist to find out the best hair care routine.

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Seborrheic dermatitis may occur on the forehead or scalp.
Image credit: Klaus D. Peter, Gummersbach, Germany, (2009, March 10.)

There are a number of reasons why pimples or blackheads might appear on the scalp, which can make it more difficult to identify scalp acne.

Scalp folliculitis is a related condition, where bacteria on the scalp cause the hair follicles to become infected and inflamed. This can result in small, very itchy red bumps.

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 look like pimples.

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.

Pimples on the scalp are relatively common and are treated in a similar way to acne on other parts of the body.

Scalp acne may sometimes be a sign of more serious conditions. When the acne does not respond to usual treatments, a person should consult their doctor to find out the best treatment plan.

When treating scalp acne, a dermatologist will often start with daily medicated shampoos. If this is not effective, they may recommend a stronger treatment.

Acne scars may take some time to fade. Avoid picking pimples on the scalp to prevent spreading bacteria or creating deep scar tissue.

Taking preventive measures may stop scalp acne from coming back in many cases.