Health

Why you’re getting pimples on your scalp and how to treat them, according to dermatologists

Summary List PlacementAcne is the most common skin condition in the United States. Although it is most common on the face, chest, upper back, and shoulders, it can also appear on the scalp. "Scalp acne may look and feel like a normal pimple that's located around the hairline or on the scalp under the hair. It can appear as a single patch of pimples or several patches, and can even affect your entire scalp," says Michele Green, MD, a dermatologist with a private practice in New York City. Here's what you need to know about the causes, treatment, and prevention of...

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Summary List Placement

Acne is the most common skin condition in the United States. Although it is most common on the face, chest, upper back, and shoulders, it can also appear on the scalp.

“Scalp acne may look and feel like a normal pimple that’s located around the hairline or on the scalp under the hair. It can appear as a single patch of pimples or several patches, and can even affect your entire scalp,” says Michele Green, MD, a dermatologist with a private practice in New York City.

Here’s what you need to know about the causes, treatment, and prevention of scalp acne.

What causes scalp acne? 

Scalp acne is due to a buildup of dead skin cells, debris, and oil which clog hair follicles, creating acne lesions, says Green.

According to Brooke Grant Jeffy, MD, FAAD, dermatologist at Spectrum Dermatology, several factors increase the risk of scalp acne, such as:

  • Increased oil production
  • Hair product build-up or sensitivity to hair products
  • Bacterial or fungal infection

Scalp acne looks like red, raised acne lesions that can appear on the scalp and hairline. But other scalp conditions may also cause pimple-like bumps that are not actually acne. These include:

  • Scalp folliculitis: Folliculitis, or the inflammation of hair follicles, often appears like acne lesions, but it is accompanied by an itchy and burning sensation on the skin.
  • Seborrheic dermatitis: If you have scaly, greasy patches on the scalp with redness, itching, and dandruff, it may be seborrheic dermatitis instead of acne.
  • Psoriasis: Psoriasis is a chronic skin disease that causes dry, cracked skin and raised red, scaly patches that feel sore and itchy. It can occur on your scalp.
  • Pilar cysts: Pilar cysts are flesh-colored benign lesions that can grow anywhere on the body, but they commonly occur on the scalp.

How to treat scalp acne 

Scalp acne can be treated at home with over-the-counter medicated shampoos. “These products work by reducing surface bacteria, excess oil, and inflammation, which results in fewer breakouts,” says Green.

Medicated shampoos are often formulated with the following active agents:

  • Salicylic acid, which treats acne by unclogging skin pores and reducing swelling.
  • Pyrithione zinc, a common anti-dandruff ingredient.
  • Ketoconazole, which helps treat skin fungal infections like seborrheic dermatitis.
  • Coal tar, an agent that can relieve itching.
  • Tea tree oil, which can help treat dandruff due to its antifungal properties.
  • Selenium sulfide, an agent used to get seborrheic dermatitis and dandruff under control.

“I suggest taking a few extra seconds to really work the shampoo into the scalp and to leave on for three to five minutes before rinsing to optimize effects. It can take six to 12 weeks to see the acne improve,” says Jeffy. 

If over-the-counter shampoos don’t improve symptoms within 12 weeks, you should visit your dermatologist so they can prescribe topical and oral antibiotics, antifungals, or oral retinoids as needed, says Jeffy.

Insider’s takeaway 

Acne commonly appears on the face, but it may also affect the scalp when dead skin cells, debris, and oil build up on the oil glands and hair follicles.

Scalp acne can be treated with over-the-counter medicated shampoos with active ingredients that reduce acne. However, severe cases might require prescription medications to treat the skin condition.

Make sure to wash your hair regularly, limit the use of hair products, and have a healthy lifestyle to prevent developing scalp acne.

“It is important that you do not wait too long to see a dermatologist for persistent breakouts. You may need oral antibiotics if your acne is severe,” says Green.

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