Scalp Acne Explained

Medically Reviewed By Reema Patel, MPA, PA-C
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Scalp acne is acne that appears near the hairline or on the scalp. It develops when your pores clog with excess oil, bacteria, or skin cells. Factors such as wearing hats regularly, washing your hair infrequently, or using hair products that clog your pores can cause scalp acne. Acne is very common and affects up to 50 million people in the United States every year. It can happen at any age, although it tends to first appear in puberty and is more common from the teen years until the 30s. 

Treatment for scalp acne may involve avoiding certain triggers, practicing hair hygiene, or using medicated shampoos. While scalp acne is very manageable, it may recur. 

This article will explain more about the causes of scalp acne and how to treat it.

What are the causes of scalp acne?

A person washing their hair
Studio Firma/Stocksy United

Like other kinds of acne, scalp acne can develop when your pores or hair follicles clog with excess oil, skin cells, or bacteria. This clogging can result from a variety of factors. For example, hormone fluctuations can increase oil production, making acne breakouts more likely.

Other causes may include:

  • washing your hair infrequently
  • wearing hats or other head coverings
  • using too many hair products, like hairspray or gel
  • avoiding washing your hair soon after sweating excessively

Cosmetics, such as makeup and skin creams, can also cause face and hairline acne. This condition is called acne cosmetica. Acne cosmetica also includes acne resulting from hair products.

What are the symptoms of scalp acne?

According to the American Academy of Dermatology Association (AADA), scalp acne can appear in different ways.

Some people may develop whiteheads, which occur when a pore closes up around a clog. You may also have papules, or small flesh-colored bumps. These blemishes can occur on the scalp, forehead, hairline, or the back of the neck.

Scalp acne may or may not be painful, depending on how severe it is.

How do doctors diagnose scalp acne?

A dermatologist can typically diagnose scalp acne by performing a visual examination and asking you about your medical history. In some cases, they may want to take a small skin sample or fluid swab to rule out bacterial or fungal infections.

What are the treatments for scalp acne?

Treatment for scalp acne can depend on the cause.

If some hair care products irritate your scalp, you may need to stop using them or switch to a different kind. The AADA recommends using products that are noncomedogenic, which means they will not clog your pores.

If you frequently wear hats or other head coverings, be sure to wash them regularly. Washing your hair after sweating excessively can also help keep your pores clear.

Some people may benefit from shampoos that contain ingredients like salycilic acid, which can help clear up acne. For localized breakouts, your doctor may also recommend topical treatments that include benzoyl peroxide, azelaic acid, or retinoids.

In severe cases, a dermatologist may also inject a corticosteroid, which is a medication that can help reduce inflammation and allow your skin to heal. People who have hormone-associated acne may also benefit from birth control or other hormonal treatments.

What is the outlook for people with scalp acne?

With treatment, the outlook for people with scalp acne is usually good. Practicing hair and scalp hygiene, washing your hats, and using over-the-counter shampoos or topical treatments may be all that is necessary.

However, if your scalp acne does not clear up or worsens, talk with your dermatologist.

Can you prevent scalp acne?

Not all cases of scalp acne are preventable. For example, you may be more prone to acne if other family members also experienced it.

If you experience scalp acne regularly, there are a few tips that may help reduce the frequency and severity:

  • Avoid wearing hats or other hair accessories that may trap sweat and dirt. If you need to wear them, wash them regularly.
  • Change hair products or taking a break from your hair or cosmetic products. 
  • Use a medicated shampoo.
  • Wash your hair gently. Harsh scrubbing may lead to inflammation and more breakouts.
  • Remove any makeup before you sleep.

There are a few other scalp conditions that may look like or occur alongside scalp acne. These conditions include:

Seborrheic dermatitis

This common skin rash is also called cradle cap. Cradle cap is common in babies, but adults can also get it. Cradle cap usually affects the scalp, but it may also appear on other areas of the body, including the ears.

Click here to learn more about cradle cap.

Dandruff

Like cradle cap, dandruff is a skin condition that primarily affects the scalp and causes small pieces of skin to flake off. Some people may mistake dandruff for scalp acne. 

Folliculitis

Folliculitis is an infection of the hair follicles. Bacteria, viruses, or fungi can infect hair follicles and cause inflammation and blemishes that can look like acne.

Frequently asked questions

Here are a few other commonly asked questions about scalp acne. Reema Patel, PA-C, reviewed the answers.

Which shampoo is best for scalp acne?

You may be able to treat scalp acne with over-the-counter medicated shampoos. These shampoos may contain ingredients like salycilic acid or coal tar, which can help remove hair product buildup and clear your pores.

Why do scalp pimples hurt?

Scalp pimples may hurt due to inflammation or infection. If you have scalp acne that hurts, talk with your dermatologist.

Does scalp acne go away?

Depending on the cause, you may be able to clear up your scalp acne simply by avoiding certain triggers. For example, if you wear hats regularly and experience scalp acne, try washing hats regularly, or you can avoid wearing them. In some cases, you may need to contact a dermatologist to determine the proper scalp treatment.

Summary

Scalp acne is acne that appears on the scalp or near the hairline. This type of acne results from clogged pores. While hormones or genetics can play a role in the development of scalp acne, external factors such as hats or pore-clogging hair products can also affect it.

Treatment for scalp acne can involve washing your hair regularly or using medicated shampoos. Some people may benefit from noncomedogenic hair products. If you wear hats or other head coverings regularly, you may need to wash them frequently or avoid wearing them altogether.

If you have scalp acne that does not respond to traditional treatments or worsens, talk with your dermatologist.

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Medical Reviewer: Reema Patel, MPA, PA-C
Last Review Date: 2022 Jul 29
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