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Scalp acne can be just as painful and itchy as facial or back acne, but it’s more challenging to treat because it’s often hidden under hair. The only advantage is that most scalp acne is concealed by hair. However, natural oils from your hair or headwear like hats and scarves can worsen existing acne or trigger new breakouts. Learning how to treat scalp acne and taking preventive measures can help ensure it doesn’t recur.
Steps
Use Topical Products
Apply benzoyl peroxide. Benzoyl peroxide is a common ingredient in acne face washes and lotions. It works by killing bacteria that clog pores and cause new acne to form. Additionally, it helps remove excess oil and dead skin cells from acne-prone areas. Benzoyl peroxide is available in over-the-counter products with concentrations ranging from 2.5% to 10%.
- Potential side effects of benzoyl peroxide include bleaching hair and clothing if too much product is used. Be cautious when applying it to your hair or scalp.
- Other side effects may include dryness, redness, burning, and possible skin peeling.
Apply salicylic acid. Salicylic acid is one of the most commonly used topical acne treatments, found in most acne face washes and cleansing wipes. This ingredient prevents clogged pores and can even help unclog existing ones, reducing the size of scalp acne or breakouts elsewhere on the body. Salicylic acid is typically available in over-the-counter topical products with concentrations ranging from 0.5% to 5%.
- Potential side effects include skin irritation and a mild stinging sensation.
Use alpha hydroxy acids. There are two types of alpha hydroxy acids: glycolic acid and lactic acid. Both are commonly found in over-the-counter acne treatments because they help remove dead skin cells and reduce inflammation. Some studies suggest that alpha hydroxy acids may also promote the growth of smoother, newer skin.
Try sulfur. Some individuals with acne find sulfur to be a helpful treatment option. It can assist in removing dead skin cells and excess oil from the body. Sulfur is often combined with other over-the-counter ingredients in cleansers or topical acne treatments.
- Note that some sulfur-based products may have an unpleasant odor.
Use stronger prescription products
Apply retinoids. Retinoids are topical medications derived from vitamin A. They prevent the clogging of hair follicles to reduce the occurrence of acne.
- Use retinoid products in the evening. Start by applying three times a week, then gradually increase to daily use as your skin adjusts to the treatment.
Try using Dapsone. Dapsone (Aczone) is an antibiotic ointment combined with anti-inflammatory properties. This gel treats acne by eliminating bacteria, cleansing the skin, and keeping pores clear. Dapsone is often paired with topical retinoids to maximize the effectiveness of both treatments. Potential side effects include skin dryness and redness/irritation.
Use topical antibiotics. Severe acne cases may require antibiotics to treat existing breakouts and prevent new ones. Antibiotics are often used with benzoyl peroxide to reduce the risk of antibiotic-resistant bacteria and can be combined with retinoids for optimal results.
- Some commonly prescribed antibiotic treatments for acne include clindamycin with benzoyl peroxide (Benzaclin, Duac) and erythromycin with benzoyl peroxide (Benzamycin).
Take oral antibiotics. Oral antibiotics may be prescribed for moderate to severe acne to reduce the growth of acne-causing bacteria in the body. They also help alleviate inflammation caused by acne. The most commonly prescribed oral antibiotics for acne are from the Tetracycline group, including Minocycline and Doxycycline.
Consider combination birth control pills. Some women and teenage girls with acne find that combination birth control pills can help manage breakouts. These pills combine estrogen and progestin to prevent pregnancy and protect against acne.
- Three combination birth control pills available in some countries like the U.S. include Ortho Tri-Cyclen, Estrostep, and Yaz.
- Common side effects include headaches, breast tenderness, nausea, weight gain, and occasional breakthrough bleeding, though some individuals may experience more serious side effects like an increased risk of blood clots. Consult your doctor to determine if combination birth control is right for you.
Ask your doctor about anti-androgens. Anti-androgens like spironolactone (Aldactone) may be prescribed for women and teenage girls who do not respond to oral antibiotics. These medications work by blocking androgen hormones from affecting the sebaceous glands in the skin.
- Common side effects include breast tenderness, menstrual pain, and the risk of potassium buildup in the body.
Preventing Scalp Acne
Wash your hair daily. While some people wash their hair every few days, this frequency may not be sufficient if you frequently experience scalp acne. Instead, aim to wash your hair daily with a regular shampoo. This helps reduce oil buildup on your scalp, lowering the risk of acne breakouts.
- Avoid using conditioner to see if your scalp condition improves. Conditioners, which moisturize hair, can trap excess oil and sebum on the scalp.
Avoid known irritants. If you wash your hair daily but still experience scalp acne, the issue might be caused by products you apply to your hair. Try avoiding styling products to see if the acne subsides. Once you identify the cause, experiment with different styling products to determine which ingredients are suitable for your scalp.
- Opt for water-based products or those labeled as non-comedogenic, meaning they are less likely to cause acne.
- Avoid applying hair care products too close to the roots. You can use gels or waxes, but apply them only to the hair strands, keeping them away from the scalp or hairline.
Let your scalp breathe. Individuals prone to scalp acne who frequently wear caps or sports helmets (like bike helmets) are at higher risk of developing acne mechanica, caused by heat, friction, or pressure. If you suspect that wearing hats or helmets is causing scalp acne, try to let your scalp breathe more often. Alternatively, if protective headgear is necessary, wear an absorbent headband underneath the helmet.
- Showering immediately after removing hats or helmets and washing your hair can help reduce the risk of scalp acne.
Brush your hair daily. Brushing your hair helps remove dead skin cells and detangle strands stuck together by natural scalp oils. This prevents scalp acne by eliminating dead skin cells that clog pores and freeing trapped oily hair strands from the scalp.
Consider getting a haircut. If you are prone to scalp acne, trimming your hair to a manageable length and thickness can help reduce breakouts. Shorter and/or thinner hair can minimize the accumulation of oil, dirt, and bacteria on your hair and within hair follicles.
Warnings
- Do not ingest salicylic acid; it is for external use only. Additionally, keep it out of reach of children. Salicylic acid is prohibited for children with flu-like symptoms as it may lead to Reye's syndrome, a potentially fatal condition.
