Scalp Acne Sucks—Here’s How to Treat It, According to Experts

You ever go to run your fingers through your hair in what you think is about to be a luxurious shampoo commercial but come to a screeching halt when your fingers run over a painful bump? This happened to me recently. After a season of back-to-back wedding-related festivities (which means lots of hairspray, updos, and blowouts), I ended up with some painful scalp acne bumps along the way.

While any dermatologist will preach to resist the urge to pop a pimple (on your scalp or face), I did the forbidden, popped a few, and ignored the rest until they eventually vanished. The good news is that scalp acne, while painful and annoying, is super common and generally simple to treat with a few small tweaks in your routine.

Some scalp acne is stubborn, and some people are more prone to it, so popping and ignoring it isn’t a great long-term strategy. Instead, listen to the advice of dermatologists Dr. Shereen Teymour and Dr. Ohara Aivaz, who we spoke to ahead, about how to treat scalp acne and get rid of it for good.

What causes scalp acne?

Numerous things can cause scalp acne, says Dr. Aivaz, including increased oil production, clogged pores, inflammation, hormonal changes, and an overgrowth of bacteria called propionibacterium acnes.

Hair products are a common culprit, which I've experienced firsthand. Just like different skincare ingredients can lead to breakouts on your face, the ingredients in hair products can do the same on your scalp. "The oils block the hair follicles, and certain ingredients irritate the skin, leading to inflammation," explains Dr. Teymour. "This type of acne is commonly seen around the hairline and roots where product buildup is most concentrated."

Is it scalp acne or scalp folliculitis?

Now, scalp folliculitis is also a term that floats around in the scalp acne conversation, but both causes are quite different. "Scalp acne is characterized by painful pimples on the scalp and is caused by numerous factors like increased oil production, clogged pores, and even hormonal changes," Dr. Aivaz explains. "Folliculitis is caused by inflammation in the hair follicle, which is typically triggered by a bacterial or yeast infection."

You may not know for sure which one you're dealing with, mainly because it's not easy to get a good look at your own scalp, and most bumps on your head will feel like—just that—a standard bump. But there are some tell-tale differences. "Similar to facial breakouts, acne on your scalp can appear as comedones, papules, or cysts along the hairline and scalp," adds Dr. Teymour. "The key difference is that folliculitis occurs when hair follicles become inflamed due to a bacterial or fungal infection, not just clogged.

As a result, the bumps are usually uniform in size, smaller, itchier, and more painful than typical acne." The good news is that the treatments are often the same for both conditions. "Generally, I recommend the same shampoos and preventative strategies as I do for scalp acne," says Dr. Aivaz.

How to treat scalp acne

A few things can help treat scalp pimples once they've already popped up:

Shampoo with salicylic acid

"I often recommend shampoo with salicylic acid for mild to moderate cases because they gently clear clogged pores without stripping the scalp of moisture," recommends Dr. Teymour. "Salicylic acid is a beta-hydroxy acid (BHA) that helps to exfoliate dead skin cells and reduce oil production, both of which are major contributors to scalp acne. It's particularly great for reducing the buildup of dead skin and excess oil on the scalp."

Shampoo with ketoconazole

Ketoconazole is another powerful shampoo ingredient to look for. "Ketoconazole-containing shampoo can help with scalp acne and also have the added benefit of helping with hair growth. I recommend using them three times a week, leaving it on for three minutes to do its thing, and then rinsing it out for maximum effect," Dr. Teymour says.

Use tea tree oil as a natural remedy

Tea tree oil's natural antimicrobial and anti-inflammatory properties make it a great option if your scalp acne is mild, says Dr. Teymour. "I love recommending this for people looking for a more natural approach. It helps reduce bacteria on the scalp while soothing inflammation." If you have sensitive skin, she suggests a patch test first since tea tree oil can be irritating to some people.

Add a targeted treatment

Targeting scalp pimples with a benzoyl peroxide spot treatment can help with stubborn breakouts, Dr. Teymour says (keep in mind they can lighten the hair). "For persistent cases, topical retinoids like adapalene can encourage cell turnover," she adds, which in turn helps breakouts go away.

Don't be afraid of sulfates

Hear us out. Sulfate-free shampoos are great for your hair, Dr. Avaiz says, but if you've got scalp acne, consider using gentle sulfates to help sop up dirt. "Many sulfate-free formulas do not lift oil off the scalp very well, so using a shampoo with sulfate can also be helpful in this case," she says.

Sometimes, more is more

Don't be afraid to combine treatments, go for prescription-strength, and increase hair-washing frequency, Dr. Aivaz says. "I like to use a combination approach when treating scalp acne. Clarifying or prescription-strength shampoos are important for lifting oil off of the scalp. Prescription-strength topical or oral antibiotics are also helpful to clear scalp acne."

So, how do I prevent scalp acne?

Once you're all clear of your breakouts, you can do a few things to keep scalp acne from coming back:

Avoid pore-clogging products

You may already be avoiding pore-clogging products on your face if you deal with acne. The same tactic can work when it comes to your scalp. "Switching to hair products that won't clog your pores is essential to prevent blockages and acne," Dr. Teymour says. That goes for all of your hair products. "You want to make sure your shampoo, conditioner, and styling products are labeled as oil-free to avoid pore clogging," Dr. Aivaz says.

Take off that hat

It's cute, but sorry, frequent use of wearing hats (we're talking for prolonged periods) may not be doing your scalp any favors. "Hats can carry bacteria and also occlude oil onto the scalp, so skip the hat if you can, or at least make sure you are washing it after each use," Dr. Aivaz recommends.

Exfoliate regularly

Just as you would incorporate a regular exfoliating face wash or peel if you were treating acne on your face, you should use the same ingredients on your scalp. "I often recommend glycolic acid for exfoliation and promoting cell turnover," Dr. Teymour says. "I find this particularly useful for people with oily hair who are prone to acne."

Final takeaway

Whether it's scalp acne or clogged follicles, don't hesitate to book an appointment with a dermatologist if these strategies aren't working. "Sometimes, if the condition is severe enough, it may warrant treatment with oral antibiotics or oral antifungal medications," says Dr. Aivaz. "So if the scalp has not improved after using over-the-counter treatments, you'll know it is time to see a dermatologist."