Pimples are a well-known condition that occurs in most individuals. It happens when the oil glands on the skin are inflamed or clogged. Sometimes, your scalp may have bacteria that can cause pimples to form. Pimple formation may indicate signs of acne.
There are different types of pimples, such as blackheads, whiteheads, cysts, and others.1 The scalp is considered the covering of the cranium. The scalp is composed of soft tissues and is a surface where hair can grow. The scalp tends to serve as a physical barrier that protects the human body from foreign objects.2 There is no particular region where pimples can occur.
Here we will thoroughly discuss what causes the pimples on your scalp to form and how to manage them. Clogged pores in your scalp or the hair follicles can cause breakouts. These breakouts, consequently, result in pimples. Pimples, hair acne, or scalp acne may irritate or cause trouble for the patient. Therefore, many affected people want to manage it and eliminate scalp acne.
Causes of pimples on the scalp
Our skin acts as a physical barrier and blocks the entry of particles and microbes from entering the body 1. The sebaceous gland is a gland that produces sebum which helps keep your body moisturised and also serves as a protective barrier. Inflammation (due to interaction with environmental agents) or clogging tends to cause pimples. When this irritation occurs on your scalp, it results in scalp acne. There are many reasons why inflammation or clogging occurs.1 These include:
- An excess of sebum production
- Keratin (a protein that helps in the formation of nails, the outer layer of skin, and hair) is abnormally produced
- Bacteria (Cutibacterium acnes)
During puberty or any stage of life, hormones may cause the glands to inflame or enlarge these glands (sebaceous) when enlarged, resulting in excessive production of sebum. Excess sebum causes inflammation or clogging, and so pimples occur.
In the case of bacteria, it grows at any place on your skin. In response to this growth, white blood cells (lymphocytes) attack the growing bacterial colony. This response damages the hair follicles and causes debris. Debris in the pores clogs them and results in pimple formation.
If you have a family history of oily skin, you are probably at more risk of acne scalp. Any of the reasons mentioned above may be the cause of scalp acne. Sometimes, two or more factors combined result in scalp acne.
Signs and symptoms of pimples on the scalp
Symptoms of scalp acne are evident and can be easily distinguished. You can feel them in your head while combing your hair or touching your scalp.
Some of the symptoms include:1
- Pimples on your scalp or hairline. It is the most prominent feature of head acne.
- Having pus-filled bumps on your scalp (whiteheads)
- Sometimes the bumps are inflamed
- Acne cysts (pus-filled cysts deep in your skin)
- Soreness on head
- Frequent episodes of irritation in your head
- Frequent and unexplained hair loss
Management and treatment for pimples on the scalp
Treatment and management of acne scalp are simple by adopting some lifestyle changes and managing your hair-cleaning routine. You can use shampoos with antibacterial agents. These agents may include sulphur and salicylic acid, which help reduce sebum production. Wash your hair and let the shampoo settle on your hair for 5 minutes. By doing so, the agents will get a chance to interact with the affected site and exert its effects.3
Antibacterial essential oils such as sweet orange, tea tree oil, and vetiver can treat pimples on the scalp.4 Topical treatments can also be used to treat acne scalp. Examples include benzoyl peroxide which should be used sparingly to avoid irritating the skin. Other substances such as spironolactone or drugs having tretinoin are effective agents.4 In antibiotics, tetracyclines, macrolides, and clindamycin can be used.4 Besides these medicines, you can use other medicines for everyday use. It is possible and recommended to use other agents (which are used to treat acne) for the scalp. These agents also act to fight against acne scalp (inflamed sebum production, bacterial presence, or excessive production of Sebum).5
10% Glycolic acid is another recommended OTC therapy for scalp pimples. It has antibacterial (bactericidal) properties against Propionibacterium acnes. The colonies of bacteria in pores and hair follicles are destroyed by glycolic acid.5
Some antifungal dandruff shampoos have ketoconazole to treat dandruff and fight against the bacteria p.acnes. This bacteria is considered to be a causative agent of pimples on the scalp. Therefore, using ketoconazole can inhibit the growth of p.acnes and treat scalp pimples.5
Jojoba oil is a home remedy for the treatment of scalp pimples. It does not have antibacterial or anti-inflammatory properties, but it reduces the amount of sebum. By controlling sebum levels, you prevent an ideal environment for the growth of bacteria. Controlled sebum levels also prevent the inflammation of sebaceous glands.5
One should keep in mind that all these medications have side effects too. Reducing sebum levels or other effects of the medications can make your scalp dry. Any drug interaction with the body can result in hypersensitivity reactions (hives, rashes, swelling, allergies, etc.). Therefore, use the medications as recommended by the prescriber. In the case of over-the-counter drugs, follow the instructions on the product label. If in case of doubt or an adverse reaction, stop the medication and contact your pharmacist or dermatologist.
How common are pimples on the scalp?
Scalp acne is relatively common. People having oily scalps or excess sebum production may have more chances of developing pimples, especially on the scalp.
Who are at risk of pimples on the scalp?
People with oily skin or a family history of oily skin are at risk of getting pimples on the scalp. Furthermore, excess sebum production can also cause pimples on the scalp.
How can I prevent pimples on the scalp?
You can prevent pimples by regularly washing your hair, controlling your sebum production and keeping your scalp free of debris.
When should I see a doctor?
If the pimples on your scalp cause excessive itching and make it impossible for you to live peacefully, then you should see a doctor. Furthermore, if you’re experiencing an adverse side effect or reaction to an OTC drug, home remedy, or medicated shampoo, you should seek medical attention from a doctor.
One can get pimples on the scalp due to excess sebum production, abnormal production of keratin protein, or due to bacteria. All of these factors cause breakouts that result in inflammation or clogging of the pores, and so pimples are formed. The evident sign of having pimples on your scalp is the presence of pimples, whiteheads, or blackheads. Itching and soreness may also occur due to pimples. OTC drugs such as benzoyl peroxide can be managed or treat pimples. Ketoconazole, 10% glycolic acid, spironolactone, and sulphur, are also considered an option for treating scalp acne. The medications or medicated shampoos may have adverse effects on the skin and can result in hypersensitivity reactions; therefore, it is best advised to use them as recommended by your doctor. One should immediately stop applying these medications if adverse effects appear and should consult a pharmacist or a dermatologist.
- Pimples [Internet]. Cleveland Clinic. [cited 2023 Feb 2]. Available from: https://my.clevelandclinic.org/health/diseases/22468-pimples
- Tajran J, Gosman AA. Anatomy, Head and Neck, Scalp. StatPearls Publishing; 2022.
- Hickman-Kirby JM. What is scalp acne? How to treat pimples on your scalp [Internet]. Allure. 2019 [cited 2023 Feb 3]. Available from: https://www.allure.com/story/scalp-acne-treatments-shampoo
- Scalp pimples: Causes, treatments, prevention [Internet]. Ro. [cited 2023 Feb 3]. Available from: https://ro.co/health-guide/scalp-pimples/
- Mbbs SM. Scalp pimples? What causes scalp acne and how to treat it [Internet]. Verdica. 2020 [cited 2023 Feb 3]. Available from: https://verdica.co/scalp-acne/