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Image of a woman touching her head representing acne on scalp

Acne on scalp – causes, symptoms and how you might treat it

Acne is mostly thought of as something you experience on the face, chest, arms or back. But scalp acne is actually very common – and can be caused by a variety of things.

Just like any other type of acne, acne on your scalp can be treated in several ways too. So, what are the symptoms? Are there any common causes you should look out for? And how might you go about dealing with it?

What is scalp acne?

Scalp acne usually takes the form of pimples and pustules on the scalp and hairline.

Unlike facial or body blemishes, acne on your scalp may not be as noticeable most of the time, but it can still be sore and uncomfortable.

Symptoms of scalp acne

Blemishes on or around the hairline generally come in three stages of severity:

  1. Blackheads and whiteheads – mild symptoms. On the surface of the skin. You may be able to feel these, but they might not be visible.
  2. Papules and pustules – moderate symptoms. On the surface of the skin. These spots can form in irritating and painful clusters.
  3. Nodules and cysts – severe symptoms. Under the skin. These pus-filled spots don’t have a head, so can’t (and shouldn’t) be popped or squeezed.

Speak to a dermatologist

Due to the area being covered by hair, it can be hard to self-diagnose scalp acne. There’s a chance you could be experiencing another complaint such as seborrheic dermatitis, a severe form of dandruff caused by a microbe which manifests in a rapid increase of the production of new skin cells. This can feel like acne cysts under your hair but would be treated differently. The only way to be sure of diagnosis is to speak to a professional.

What causes acne on your scalp?

Acne typically results when dead skin cells, bacteria and oil clogs pores and hair follicles, becoming trapped. This build-up can itself be caused by a variety of issues and is not specific to all scalps and skin types.


If your parents experienced acne around their scalp or hairline, you may be more likely to do so. That said, breakouts can occur on different places for different people, even within families.


Bacterial infections can lead to scalp acne, and can occur for several reasons:

  • Not washing your hair thoroughly or frequently enough. This can cause a build-up of dead skin cells and bacteria. Always wash after a workout, as you are likely to experience a great deal of sweat around your hairline.
  • Washing your hair too frequently and using too many hair products can, at the other extreme, also pose a problem, resulting in product build-up from hairspray, wax, shampoo etc. Finding a happy balance in your routine is recommended.
  • Wearing tight headgear for long periods of time can cause irritation around the scalp, and lead to a build-up of sweat. Wearing hats made from more breathable material, taking headgear breaks (if safe to do so) and avoiding wearing them in hot temperatures may help.


Acne is especially common around puberty, when certain hormones – including testosterone – begin to fluctuate and affect sebum production. Certain medications and menstrual cycles can also affect hormone production, and sometimes cause or inflame breakouts.


Travel, stress, and lack of sleep can also cause scalp acne. When cortisol levels rise, your body is more likely to produce oil which can, in turn, cause acne.

How you might treat acne on your scalp?

Cleansing and gentle exfoliating are essential when treating and preventing any type of acne, it may not always be enough to successfully eliminate it altogether. However, there are a few specific options and treatments you might consider to help get rid of scalp acne.

Switching your shampoo

Try a medicated shampoo and conditioner. Nizoral and Aqua Glycolic products can help exfoliate dead skin cells and eliminate bacteria and fungus on the scalp. Glycolic acid is an excellent exfoliator and particularly effective at treating the scalp.


Antibiotics are sometimes prescribed by doctors to help treat acne on the scalp and can come in the form of tablets or oral creams. These can be very effective and are often prescribed on a long-term basis.

Chemical peels

Chemical peels act by removing the top layer of skin to promote accelerated cell regrowth, which can then help in the elimination of spots and scarring. They can also be used to exfoliate dead skin and remove excess oil and dandruff.

Steroid Injections

Steroid, or cortisone, injections involve a shot of a synthetic hormone related to the stress hormone cortisol into a particularly problematic pimple or cyst. They provide short-term relief of inflammation within a few days.

Light Therapy

Blue light therapy is most commonly used to address breakouts as the wavelength has an antimicrobial effect. It can work on the scalp and hairline too.


Microneedling is sometimes suggested for use on acne scarring on the face and body, though not necessarily on the scalp. Ask your doctor if you are interested in learning more about it.


  • Using your nails when washing your hair can damage your scalp, potentially leading to irritation and infection. Try massaging with your palms or using a shampoo brush instead. And like acne elsewhere on your body – don’t pick.
  • Using dry shampoo in-between washes can help keep your hair clean – but using too much may result in product build-up. Try not to use it as a shampoo alternative.
  • You can treat acne on your scalp with regular acne products you would use elsewhere but avoid using benzoyl peroxide as it can lead to bleaching and discolouration.


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