Acne on the scalp

Acne often has significant emotional and psychological impact on the individual who suffers. Some of the contributing factors to the development of the condition will include clogged pores due to skin or hair oil, small follicles, bacterial growth and poor hygiene. The causative factors for scalp acne are much the same as acne found on the face and back.


Scalp acne is common in both men and women and can affect people of all ages. The condition will cause small pustules that look like whiteheads with the yellow cast inside the hairline. Scalp acne is often triggered by periods of high stress in an individual’s life. The stress can trigger a change in hormonal balance and results in acne. These same hormonal changes can also trigger acne on the face and body.


Scalp acne can also develop when the scalp has too much oil and the hair has not been washed. Sometimes the products used to watch the hair have excess amounts of oil and can trigger acne. Triggers also include mites, bacteria and yeast infections. (1)



Scalp acne can be present in mild, moderate and severe forms. Other medical terms for this condition are scalp follicullitis or necrotia miliaris. Mild cases of scalp acne will occur mostly at the hairline. These blemishes are often small, contain a core and are crusty.


The more severe cases of scalp acne have blemishes which are larger, inflamed or papules. These are black in color and leave scars similar to ones left by chickenpox. These more severe cases are called necrotica miliaris and can result in hair loss when the bacteria kills the hair follicle. (2)


Treatment for scalp acne will include using cleaning products that contain salicylic acid. This should be applied with a cotton ball. The salicylic acid can cause excessive drying and should only be applied to the affected area which is why a cotton ball is used for application and it is not applied throughout the entire scalp.


Dermatologists recommend using a mild shampoo to control the increased oil production which is often a problem for individuals who suffer from scalp acne. The scalp and hair or should not be treated with benzyl peroxide because the peroxide will change the color of the hair, even blonde hair. Anti-dandruff shampoos can be used in these cases.


In some cases the dermatologists will culture the acne to determine the antibiotics which can have a beneficial effect. Physicians will order either oral or topical forms of antibiotics and some also recommend the use of mild topical steroid creams and lotions to decrease the inflammation on the skin that will decrease the production of blemishes.


Oral antibiotics which are often prescribed include tetracycline, doxycycline, ethrythromycin or cotrimoxasole. Oral antihistamines are used to decrease the systemic response to the skin, decreasing the inflammation and therefore decreasing the number of outbreaks.


Scalp acne is not as popularized in the media as “regular” facial and back acne. However, it is more prevalent than you might think. It also isn’t as evident since most people who suffer from the blemishes have them inside the hairline. Treatment of scalp acne is very important so they don’t leave pock type scars on the scalp which can kill the hair follicles and thin the hair.
(1) Mayo Clinic: Acne

(2) Archives of Dermatology: Acne Nectrotica; Relation to Acne Necrotica Miliaris and Response to Penicillin and Other Antibiotics

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