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

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.

Genetics

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.

Infections

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.

Hormones

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.

Lifestyle

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.

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

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

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.