Angry, annoying pimples aren’t just limited to your face and body: Scalp acne is a very real struggle too—and can be a major headache to deal with. These breakouts aren’t as common as the ones on your chin, forehead, or back, but “they’re not exactly rare either,” Lindsey Zubritsky, MD, a board-certified dermatologist at Premier Dermatology and Skin Cancer Center in Ocean Springs, Mississippi, tells SELF. Consider that your scalp is covered with a lot of oil-producing glands and hair follicles. And if they get clogged with excess oil, dead skin cells, and/or product buildup, it’s not unusual for a few pimples to pop up, Dr. Zubritsky explains.
Not all scalp blemishes, however, are acne. So before you start self-diagnosing, scroll below for everything you need to know about zits on top of your head—including how to treat them, how to prevent them, and how your styling products might be contributing to the problem.
What is scalp acne?
Howard Sobel MD is a clinical dermatologist at Lenox Hill Hospital New York City. He tells Self that, just like acne breakouts on the face, acne can also appear on your scalp as whiteheads, papules and cysts.
However, if you’re experiencing more tender-to-touch or super itchy bumps, you may actually have scalp folliculitis, not acne. This skin condition looks pretty similar, and some of the treatment recommendations are the same—like avoiding pore-blocking ingredients and regularly washing your hair. What is the main difference? Folliculitis is a condition where hair follicles are inflamed, not just clogged. This can be caused by a fungal or bacterial infection. These spots are monomorphic, meaning they’re all the same size, smaller, itchier, and more painful. Dr. Sobel explains.
What causes scalp acne?
“Scalp pimples can be caused by numerous factors, including but not limited to bacteria, hormones, and excess oil production,” Dr. Zubritsky says. And while head zits don’t necessarily favor a certain hair type or texture, Tiffany Clay-Ramsey, MD, a board-certified dermatologist at Epiphany Dermatology in Atlanta, tells SELF that they’re more common in folks with thin, straight strands—since that hair type tends to be oilier (which in turn can lead to congested pores). Pimples are more common on scalps of people with oilier hair.
Other possible culprits include heavy hair care products such as gels, pomades, waxes, and hairsprays—all of which can trigger acne cosmetica (breakouts stemming from things applied directly to the skin), per the American Academy of Dermatology. Frequently wearing a hat may contribute to breakouts too—the friction can irritate your scalp and the material can trap oil and bacteria, Dr. Zubritsky says.
In more serious cases, irritating spots hidden in your hair could be a sign of an underlying condition such as lichen planopilaris, scalp psoriasis or seborrheic dermatitis (scaly, itchy patches). “This is especially true if you’re experiencing more concerning things like bleeding, flaking, or pain,” Dr. Zubritsky adds—in which case, it’s best to see a dermatologist for an accurate diagnosis.
How to treat scalp alopecia at home
Whatever you do, “absolutely do not squeeze or pop the pimples,” Dr. Sobel says. By doing so, you risk creating open wounds that can be an entry point for bacteria. By touching the wounds with your fingers, you can increase your chances of getting an infection.