What It Means When You Get Breakouts on Your Scalp

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Some might say 2019 was the year of scalp care in the beauty industry: we are more aware than ever of issues lingering beneath our hair, and it’s more than just product buildup. One thing many of us have probably experienced, but don’t talk about, is “scalp acne”—let’s be honest, it’s not exactly brunch conversation. However, more often than not, a bump that resembles a pimple on the scalp is not actually acne at all. Here, experts explain.

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Why It Happens
According to Delray Beach, FL dermatologist Dr. Janet Allenby, the scalp can have acne outbreaks like the face does, but it’s less common and usually associated with those who have severe types of facial or body acne. “Bumps on the scalp are usually not acne, but rather folliculitis, the result of an inflammatory reaction around the hair and sebum follicles and can be caused by many things, but most frequently, hormonal and excessive sebum (oil) production are the biggest influences,” she explains. Should you have actual scalp acne, New York dermatologist Dendy Engelman, MD says the fastest treatment is an injection of cortisone, which your dermatologist can administer.

“Folliculitis is perfectly normal and can develop on any areas of the skin that have hair follicles,” says Harrison, NY dermatologist Jennifer Silverman Kitchin, MD. “I find that it’s more common in the warmer, humid weather and is triggered by the accumulation of skin oils, debris, bacteria and dirt. In mild cases, it tends to clear up on its own, but in severe or chronic cases, a course of antibiotics (oral and topical) can be used.”

Washington, D.C. dermatologist Brenda Pellicane, MD has found that dry shampoo can often exacerbate this. “Possibly from direct occlusion of the follicle, but also indirectly, as patients tend to shampoo less often when using dry shampoo, thereby increasing buildup.”

The bump could also be a scaly patch that results from dandruff or eczema. "Scaly patches on the scalp are more often seborrhea, aka dandruff, which is also an inflammatory problem,” says Dr. Allenby. It can be tempting to pick at it or just scratch it off, especially if it looks and/or feels like a scab, but Dr. Kitchin advises not to irritate it, as it can lead to the development of an infection.

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How to Treat It
First and foremost, all the experts interviewed agreed that keeping your scalp clean and oil-free as much as possible, and washing your hair after intense exercise (scalp scrubs are everywhere now and a great way to exfoliate away buildup) is key. If you think it's related to dandruff, Dr. Allenby says over-the-counter anti-dandruff shampoos and conditioners should clear it up. We like Phyto Phythéol Oily Hair Purifying Scalp Exfoliating Shampoo ($26), which strips the bad stuff out of your hair while keeping the good oils intact, so your hair looks shiny and clean, not dull. 

If you think it's acne, New York dermatologist Peter Chien, MD, recommends trying an over-the-counter benzoyl peroxide wash like Panoxyl 10% foaming wash and using it like a shampoo treatment for the scalp. “If that doesn’t help, definitely follow up with a board-certified dermatologist to determine the issue and get it under control,” he says. Plus, as Wilmington, NC dermatologist Kendall Egan, MD notes, "sometimes skin cancer can look like acne, so when in doubt, it’s always the best move to see a professional."