How to Get Rid of Scalp Acne Permanently, According to Dermatologists
There you were, innocently rubbing your head or brushing your hair, when all of a sudden, ouch: You hit some kind of weird little bump and it seriously hurts. Similar to the bumps that can form on your face, back, or chest—scalp acne is something that can happen to anyone, anytime.
Meet the Experts: Mona Gohara, M.D., board-certified dermatologist at Dermatology Physicians of Connecticut; Peterson Pierre, M.D., dermatologist and founder of Pierre Skin Care Institute.
Scalp acne can sprout around your hairline or underneath your hair itself, which can make combing, brushing, or even shampooing annoying and often painful. So, what can you do? Read on to find out what could be causing your scalp acne and what you can do to get rid of it—plus, how to keep those pesky pimples from coming back.
What is scalp acne?
Scalp acne refers to pimples and inflamed bumps that develop on the scalp, says Mona Gohara, M.D., board-certified dermatologist at Dermatology Physicians of Connecticut. “These can range from small, itchy pustules to larger, painful cysts.” Scalp acne is often similar to other forms of acne but is uniquely influenced by hair and scalp conditions, she explains.
Scalp acne is pretty much your typical acne that occurs on the scalp, says Peterson Pierre, M.D., dermatologist and founder of Pierre Skin Care Institute. “It can have whiteheads, blackheads, pimples, and cysts.” It can be tender and inflamed just like acne anywhere else on your body, he notes.
What causes scalp acne?
Similar to acne anywhere else, scalp acne can have multiple triggers. Per Dr. Gohara, here are some of the most likely culprits:
Excess oil production: Overactive sebaceous (oil) glands can mix with dead skin cells and sweat, clogging hair follicles.
Product build-up: Hair products such as gels, or dry shampoos can leave residue that clogs pores.
Hormonal changes: Hormonal imbalances, such as during puberty, menstruation, or stress, can increase oil production.
Fungal or bacterial infections: Infections of the hair follicles, such as folliculitis, can lead to inflammation and pimples.
Sweat and friction: Wearing hats or helmets for extended periods can trap sweat, leading to blocked pores and irritation.
Dietary factors: High-glycemic foods and dairy may contribute to increased oil production and inflammation.
How to treat scalp acne
First, some tips on how to cope with your scalp pimples and not make the condition worse. “Don’t pick or scratch,” says Dr. Gohara. “Picking at scalp acne can lead to scarring or secondary infection,” she explains. Similarly, use gentle hair tools and avoid brushes or combs that may irritate the scalp further, she advises.
Remember that your scalp is simply an extension of your skin, says Dr. Gohara. “Wash your hair regularly to remove sweat, oil, and product build-up. She also recommends avoiding heavy or oily styling products that may clog pores. However, like typical acne, maintaining good hygiene may not be enough to treat your scalp pimples.
Luckily, there are multiple treatment options you can try. Over-the-Counter (OTC) medicated shampoos are one of the simplest ways you can address the issue, says Dr. Gohara. She suggests trying one of the following:
Salicylic acid shampoos: Help exfoliate dead skin cells and unclog pores.
Ketoconazole or zinc pyrithione shampoos: Effective for fungal-related scalp acne or dandruff.
If the shampoo route doesn’t prove effective for you, topical antibiotics and retinols can be helpful—although somewhat inconvenient depending on how much hair you have, notes Dr. Pierre. According to Dr. Gohara, you can try:
Benzoyl peroxide (2.5%-5%): Can be applied directly to affected areas (use caution as it may bleach hair).
Topical antibiotics: Clindamycin gel can reduce bacterial infections.
And if treating your scalp acne from the outside doesn’t prove effective for you, your doctor may prescribe oral medications, says Dr. Gohara, such as oral antibiotics, hormonal therapy (like birth control pills), or in severe cases, isotretinoin (aka Accutane).
How to prevent scalp acne
To avoid painful scalp pimples in the future, you’ll want to wash your hair regularly to avoid excess oil accumulation, says Dr. Gohara. She also recommends opting “for hair care products labeled ‘non-comedogenic’ or ‘oil-free’ to minimize pore-clogging.” You can also consider other shampoos with tea tree oil or glycolic acid if your scalp tends to be oily, Dr. Pierre adds.
Dr. Gohara also warns that you should try to limit adorning any hats or helmets. And “if wearing headgear, ensure good airflow or clean liners regularly to prevent sweat build-up.”
And while we know this one is easier said than done, consider stress-relief techniques, as stress can exacerbate acne due to hormonal fluctuations, says Dr. Gohara.
When to see a doctor about scalp acne
If you’ve tried all the OTC remedies and you’re still struggling, you should see your dermatologist right away, says Dr. Pierre.
More specifically, if you find that you are developing chronic, persistent, or painful lesions, Dr. Gohara recommends you consult with your dermatologist. Likewise, “large, painful cysts or nodules may require prescription medications or drainage by a professional,” so don’t wait to make an appointment.
Lastly, if you experience any signs of infection, such as fever, spreading redness, or discharge, Dr. Gohara advises to tell your doctor ASAP.
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