Itchy red pimples on the scalp are very common. These pimples on the scalp are called scalp acne or folliculitis (inflammation around skin follicles).
Pimples can occur anywhere on the body with a hair follicle, including the head's scalp and back. There are two likely culprits on the scalp when it comes to pimples on the scalp: common acne and folliculitis. Similar to acne, folliculitis is an inflammatory response to things such as fungi or bacteria. The bacteria related to scalp acne are the acne bacteria (p. acnes), while the bacteria most commonly found in folliculitis is staphylococcus.
What causes folliculitis (scalp acne)?
Scalp acne AKA Folliculitis starts with dead skin cells and oil clogging the scalp hair follicles' opening. The most common cause for clogged skin pores on the scalp is sweating, humidity, and excessive use of your hair products. Once the hair follicles are clogged, they accumulate bacteria, and fungi, which in turn cause skin inflammation, redness, itch, and pain.
You may also experience traditional acne around the hairline and back of the neck if you are prone to facial acne. In severe cases, the scalp pimples and blemishes can be large and deep, resembling cystic acne. These conditions can cause pores to clog and spots to develop and, luckily, respond to the same treatments.
Four main factors contribute to acne: increased sebum (oil produced by your skin,) buildup of dead skin cells, bacteria known as Propionibacterium acnes (P. acnes), and inflammation. When the skin follicle becomes clogged and sebum gets trapped underneath, bacteria thrive on the excess oil, and inflammation occurs around the affected area.
8 common causes of scalp pimples (folliculitis)
- Oil-based hair products
- Clog poring styling gels
- Not washing your hair.
- Wearing hats
- Sweat accumulation
- Hormonal changes
- Medications (steroids)
- Wrong Diet
How can I prevent scalp pimples?
Scalp folliculitis is most commonly caused by humidity and sweating. The way to prevent scalp folliculitis is by washing the hair every day and avoiding oil or greasy hair products. Many hair products contain comedogenic compounds that can clog the scalp skin pores. Avoiding hats, especially in summer, will reduce sweating and humidity for the scalp and help prevent scalp folliculitis.
Take a look at your hair products.
Many hair products cause pore-clogging (comedogenic) ingredients that can lead to plugged follicles and breakouts. Popular comedogenic ingredients that you may find in hair care products include sulfates and Laureth-4. Another primary culprit to scalp acne is dry shampoo; it can easily block pores and prevent the skin from breathing. You also want to be wary of waxes, hair sprays, and clays.
Wash your hair regularly.
Did you know that your head has over 100,000 oil glands on the scalp?! That's a lot of potential for sebum production. If you are prone to oily hair, you'll want to make sure you're washing your hair regularly with warm water - even if you skip the shampoo - especially after any activity that causes you to sweat. Frequent shampooing will not harm your hair. If you have scalp pimples, you should shampoo every day. This will help avoid buildup around the scalp.
Revisit your shampoo
For shampoo days, consider finding a product that is designed to treat and prevent breakouts. Look for over-the-counter anti-dandruff shampoos that contain ingredients such as salicylic acid, cortisone, and coal tar. These can reduce dandruff and oil production on the scalp and help treat inflammation and dryness. The best types of medicated shampoos for people with scalp acne and scalp folliculitis are shampoos that contain selenium sulfide. Selenium sulfide is antibacterial and antifungal and can help with scalp folliculitis. Another kind of shampoo that is beneficial for people with scalp pimples is Nizoral. This shampoo contains ketoconazole, an FDA-approved antifungal, and antifungal medication. It can help with both scalp acne and facial fungal acne.
Tight hats can cause sweat and humidity to build up underneath and cause the scalp to experience folliculitis and acne symptoms. Headbands and bandanas may also pressure and rub the scalp, triggering breakouts on the scalp and forehead.
An exfoliating treatment, once weekly, can do wonders in helping you clear up your scalp blemishes. There are scalp exfoliation treatments on the market that are formulated to rid excess buildup and alleviate irritation, but here is a simple DIY scrub:
Mix the following ingredients and apply to the scalp. Gently massage for 30 seconds and rinse thoroughly.
- ¼ cup warmed jojoba oil
- ¾ cup granulated sugar
- 5 - 6 drops of tea tree oil
- 1 teaspoon of apple cider vinegar
- 1 teaspoon of raw honey
Change up your diet
Research suggests that the foods you consume can affect oil production, hormones, and inflammation - all major factors in acne development. For an acne-fighting diet, try limiting dairy and refined sugars and incorporating more "whole" foods rich in vitamin A, vitamin C, omega fatty acids, fiber, antioxidants, and zinc.
What is the best treatment for pimples on the scalp?
The best products to unclog scalp hair follicles are medicated cleansers and creams that contain salicylic acid, AKA beta-hydroxy acid. Salicylic acid cleansers and creams can unclog the scalp skin pores and significantly reduce the risk for scalp "acne." There would need to add to the scalp treatment cream and shampoo some oral antibiotics (minocycline).
Scalp pimples aren't just a nuisance. When left untreated for too long, these bumps can grow and turn into cysts, which may need to be professionally trained and have the potential to cause scarring. Whatever your treatment route, you will have to be patient. Pimples on the scalp are exceptionally stubborn and can be tough to heal. Here are some ways you can get your breakouts under control.
Leave pimples alone
The first thing is never to touch, pick, squeeze, poke, or scratch at your pimples, even if the temptation is high. Picking at blemishes can spread germs and dirt from your hands to the affected area; it can also cause the bacteria to spread and exacerbate existing breakouts. You'll also want to be careful when washing and brushing your hair; don't apply too much pressure, or irritation can occur. Picking acne on the scalp can lead to further infections that lead to larger problems such as hair loss and scarring.
Incorporate products that contain salicylic acid
Some of the best products on the market to unclog scalp hair follicles are medicated cleansers and creams that contain salicylic acid. Salicylic acid can unclog the scalp skin pores and significantly reduce the risk of scalp acne. It is also known to help treat dandruff and other scalp conditions.
The right treatment for scalp folliculitis will be a consistent routine that combines a medicated salicylic acid 2% cleanser with a medicated antifungal shampoo or tea tree oil shampoo. Tea tree has antimicrobial and anti-inflammatory properties, making it an excellent, natural solution to several skin conditions.
How to use MDacne medicated salicylic acid 2% cleanser for scalp acne?
- Gently shampoo hair and scalp - rinse with warm water.
- While hair is still wet, massage a liberal amount of the medicated MDacne cleanser onto the scalp.
- Leave the cleanser on the scalp for 3- 5 minutes.
- Rinse out thoroughly and follow with your favorite comedogenic-free conditioner.
For best results, use the medicated cleanser 2 - 3 times per week.
What are the best prescription treatments for scalp pimples?
If over the counter treatments don't seem to be working, you may need a prescription treatment to reduce inflammation and expedite healing. Your Dermatologist may recommend oral antibiotics such as minocycline and, in more severe cases, Accutane.
Best supplements for people with pimples on the scalp (folliculitis)
Taking supplements is a good addition to the topical treatment of scalp acne. The most important vitamins for facial and scalp acne are Vitamin B5, Vitamin A, and zinc, taken in the right doses. Try to avoid the "one size fits all" skin and hair supplements. This supplement contains high amounts of biotin, which are believed to cause more acne breakouts, and only small amounts of Vitamin B5 and Vitamin A, which help with facial and scalp acne.
If you are looking for scalp acne vitamins, check out MDacne's skin clearing vitamins + minerals. These supplements, specially formulated for acne people, contain high amounts of the specific vitamins proven to help with acne (Vitamin B5 and Vitamin A and the minerals Zinc and Selenium) and only tiny amounts of biotin. For more info on these supplements, please check this link.
To find the right acne treatments for your unique skin, take the free skin assessment by clicking here.