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Scalp acne: Causes and Treatments

Updated: Jun 10

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A man touching his scalp and looking in the mirror

Scalp acne often forms due to a complex interaction between genetics, scalp oil (sebum) production, skin microbiome and the immune system. Similar to acne on other parts of the body, acne on the scalp is a disease that directly affects the pilosebaceous unit – which includes the hair follicles, shaft, the sebaceous gland and other parts of the skin. For instance, excessive production of hormones can cause the sebaceous gland to produce an abundant amount of sebum (natural oil produced by the skin). Being a nutrient for acne-causing bacteria (Cutibacterium acnes), this excess sebum facilitates the growth of such bacteria on the skin, encouraging the formation of acne.

An illustration of the layers of oily skin

Although it may seem like a challenging task, there are many ways to get rid of scalp acne and prevent it from forming again in the future. This article will discuss the different types of scalp acne, its causes and the various ways to prevent and cure acne on the scalp.


What is scalp acne?

Scalp acne refers to the formation of pimples on the scalp or hairline. Although it may be surprising to learn that acne can occur on the scalp, it is actually rather common for the scalp to be a pimple-prone area. This is due to its numerous pores, hair follicles and abundant amount of sebum. Some common causes of scalp acne include haircare products that are not washed off properly, such as shampoo, conditioner and hair gel, and the fluctuation of hormones.

Acne on the scalp is easily irritated, and its symptoms can therefore quickly worsen. An example of a severe form of scalp follicular occlusion disease is dissecting cellulitis of the scalp. If left untreated, it can progress rapidly and scar, resulting in bald patches. Be sure to see a dermatologist or doctor as soon as possible.

Causes of scalp acne

Scalp acne is mainly caused by the buildup of natural oils, or other substances clogging up the hair follicles. Substances such as hair products, sweat, bacteria, and fungus can contribute to the clogging of hair follicles, causing scalp acne.


A woman washing her hair with shampoo in the shower

Hair products such as shampoo, conditioner, gel and wax can clog hair follicles on the scalp if they are not properly washed off after use. It is extremely important to wash these products and chemicals off of the scalp in order to prevent the scalp from developing acne.


2. Sweat

Two people enjoying jogging in a park and looking at one another

When sweat is produced in the scalp and not immediately washed off, it can clog the hair follicles, encouraging the growth of scalp acne. Scalp acne tends to form especially when any type of headgear is worn such as a helmet or a hat. In order to prevent the build up of sweat on the scalp, it is important to wash your scalp as soon as possible after a hot day or after exercising.

A 3D illustration of bacteria moving around

Impetigo is an infection caused by the overgrowth of bacteria on damaged areas of the scalp. Common causes for a damaged scalp include excessive scratching or washing your scalp using your fingernails. If the scalp is damaged, the various bacteria indigenous to the scalp can infect these damaged areas of the scalp, causing severe scalp acne. Thus, it is important to ensure the scalp is not being damaged, to prevent impetigo.

4. Genetics

Similar to other forms of acne, genetics affect the formation of scalp acne. If one or more of your family members suffer from scalp acne, there is a high chance that you might suffer from it as well.


Similar to facial and body acne, high stress levels can cause an increase in scalp acne. Causes of high stress levels include travel, lack of sleep, work and academic stress. Studies have shown that these high stress levels can induce high levels of cortisol in your body, causing increased levels of sebum. This excess sebum then results in increased acne by clogging the hair follicles in the scalp. Therefore, it is important to keep regulated stress levels to keep scalp acne to a minimum.


High levels of androgen hormones can cause an increase in sebum production, encouraging the formation of acne on the scalp and other parts of the body. It can also activate changes in the activity of skin cells and the clogging of hair follicles by bacteria on the skin, further encouraging the formation of scalp acne.



How can you cure Scalp Acne?

Over-the-counter medications are generally not effective in curing acne. If you are concerned about your acne, it is vital to see a dermatologist and follow their instructions. A dermatologist is able to determine the root cause of scalp acne and as a result, prescribe the most suitable treatment for you. The most common treatments for scalp acne are ointments and oral medications prescribed by the doctor or dermatologist.


Some examples of effective topical medications used to treat scalp acne are differin gel or benzoyl peroxide gel. They can be used to treat any type of acne because they unclog pores, tackling the root cause of the formation of acne. These medications can also be used as an acne preventative if you are afraid of acne recurrence.

Other topical medications such as topical antibacterial creams, are also available and can be used in combination.


Oral medications include antibacterial tablets, vitamins, and herbal remedies. Antibiotics are taken orally if the acne is severe. On the other hand, vitamins and herbal medicines might be able to supplement the treatment of mild and moderate acne.


Schedule a consultation today and start your acne recovery journey today.


How long does it take to cure scalp acne?

If the scalp environment is regulated and topical and oral medications are used, the symptoms of scalp acne should improve. Otherwise, it could be a sign of a more complex underlying disease. Do feel free to contact our clinic, where we can thoroughly assess the situation of your scalp and acne.


How can you prevent scalp acne?


1. Wash your scalp using the correct shampooing method

A man's hair being washed with shampoo while he lies down

In order to avoid scalp acne, it is important to shampoo the right way. Before shampooing, first wet your hair to remove superficial dirt and debris, then gently massage the shampoo into the scalp with little lukewarm water. When rinsing out the shampoo, ensure there is no shampoo left on your hair or scalp. Shampoos that contain harsh chemicals might aggravate your acne. Choose shampoos with moderate cleansing power in order to get rid of and avoid scalp acne.


2. Dry hair thoroughly

A woman wearing a towel and drying her hair in front of a mirror

If you have thick or long hair, you may find it difficult to air-dry your hair quickly. It is important to dry your hair thoroughly with a hair dryer after towel-drying. If your hair is kept wet before bed, bacteria and fungus can easily grow and multiply, causing scalp acne.


4. Avoid hair styling products

When scalp acne occurs, avoid irritating the scalp and affected area as much as possible to avoid aggravating the condition. It is important to avoid the pimple area when brushing your hair. Hairdressing products that can irritate the skin should also be avoided.


5. Lifestyle modification

Similar to acne on the face, certain lifestyle modifications are necessary to prevent acne from forming on the scalp. Try to lead a healthy lifestyle by taking into consideration nutritional balance when eating, getting plenty of sleep, exercising regularly, and keeping stress levels low. Improving your lifestyle not only helps prevent acne, but also nurtures beautiful skin and leads to a healthy mind and body.


In addition to the above-mentioned changes, in order to truly ensure your scalp is free from acne in the long run, it is important to keep your scalp and gut microbiome balanced. Various research studies have shown the relationship between the gut and skin microbiome. Therefore, ensuring the consumption of probiotic foods or supplements can decrease the chances of acne forming on your scalp. In order to directly balance your scalp’s microbiome, you can also consider products that contain less harsh chemicals.


Conclusion

Although acne on other parts of the body can be treated using chemical peels and laser treatments, scalp acne cannot use these treatments due to its location. Therefore, scalp acne is usually treated with topical and oral medications. Scalp acne is often more difficult to treat than acne on other parts of the body and there is a higher chance that it becomes more severe. While it is important to receive proper treatment for scalp acne, it is also important to ensure preventative measures are taken, such as shampooing properly and thoroughly; improving your lifestyle and diet, and lastly, ensuring your scalp microbiome is kept balanced in the long-run.


This blog post was medically reviewed by Dr Summer Zhang.

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