What Is Scalp Acne? Find Out Causes and Treatment Options

May 2024 · 6 minute read

I have a confession: I wash my hair everyday. Which, in the year 2021, usually incites looks of incredulity before everyone in the room launches into the usual "but it's so bad for your hair" lecture.

Thanks, I know.

I've tried repeatedly in the past to try and rehabilitate my daily washing habits, but I've always failed for a variety of reasons — mainly scalp acne. Yup, you read that right. Acne doesn't only just happen on your face or your back.

When it comes to scalp acne, think general congestion and little baby whiteheads around the hairline, plus a few painful cystic pimples aching on the top, sides, and back of my scalp. Not cute.

I've been dealing scalp acne since I was 12, and while it's (obviously) not fun, washing my daily daily has given me some relief. But I wanted to learn more about the condition, and hopefully help others like me in the process — that's why I went to a few experts to find out more.

What Exactly Is Scalp Acne?

According to celebrity esthetician and dermatological nurse Natalie Aguilar (you might have heard of her clients Sophia Vergara and Rita Ora), the skin of our scalp behaves differently from the skin on our face.

"The skin on our scalp is much thicker, more vascular, and has more hair follicles and oil glands than any other part of the body," she explains. "The sebaceous glands also secrete oil that help to keep the hair on or scalp protected, and oftentimes an excess of oil secretion can occur." This is what can lead to pimples when said sebum congests the follicles on the scalp.

What Causes Scalp Acne?

It isn't just excess oil that causes blemishes — styling products can play a major factor in triggering scalp acne.

"The biggest is hair conditioner," Aguilar shares. "Most conditioners call for application mid-length of hair to the ends, but most mistakenly apply into the scalp. Without rinsing the product off completely, the conditioner can cause clogging and lead to acne on both the scalp, neck, and back." She also notes that her clients who use hair gel or hair spray who also forget to cleanse their scalp frequently tend to find themselves more prone to scalp acne.

What's the Best Way to Treat Scalp Acne?

If the scalp acne is caused by too much oil production or an unclean scalp, is it actually better to cleanse more frequently? While Aguilar would recommend washing and styling daily to ensure that the scalp is clean, others disagree.

According to VP of technical education at R+Co Adam Federico, washing too often will also contribute to an excess of sebum on the scalp. "Scalp acne can be caused in two main ways: over-washing or under-washing," says Federico. "Under-washing can cause a buildup in oils, but over-washing can cause the scalp to hyper-produce oils in an effort to compensate for dehydration."

He says that the sweet spot would be to wash two to three times per week, and that one of those washes should be with a clarifying shampoo.

As someone who was raised to wash her hair daily, the process of washing my hair less often simply feels unnatural. But it can seem especially unnatural if you're mindful about the daily state of your skin.

Dermatologist and SEEN Hair co-founder Dr. Iris Rubin points out, "What's on your hair is on your skin. Residue from hair products can transfer from your hair to your pillowcase, and then to your face. And even rinse-off hair care products can leave a residue," she says.

Laying my face in a mop of city-polluted tresses? No thanks. So, what's an oily-haired person to do? While Rubin says to use non-comedogenic hair products and to wash more frequently, Federico recommends using a silk scarf to wrap your hair up at night, as well as a generous amount of sanitizing spray for your hair (R+CO's BIO DOME Hair Purifier + Anti-Pollutant Spray works perfectly for this — it's basically Purell for the hair).

VIDEO: Here's All You Need to Know About Salicylic Acid

I'm Doing Everything Right and Still Can't Get Rid of My Scalp Acne — Help!

In this case, it's time for a little more scalp management. Aguilar mentions that scalp acne can be caused by product buildup and sweat. So if you're constantly using products for your hair or working out without cleansing your hair afterwards, she suggests investing in cleansing products that have some sort of anti-acne ingredients in them, like clay, salicylic acid, and tea tree.

But if you can't shampoo, try rinsing your scalp with some diluted apple cider vinegar (one part vinegar to three parts water). Federico enthuses the use of ACV to prevent acne. "I like products that contain apple cider vinegar and/or salicylic acid," he says. "Wash two to three times weekly, implement a scrub, apple cider vinegar rinse and a deep conditioner to prevent dehydration. You can't go wrong!"

Well, you could be going wrong with your styling products. Dr. Rubin also suggests examining your favorite products' ingredient lists to check for non-comedogenic culprits, and mentions that there are a few you should stay wary of.

"Ingredients in hair care products that can potentially clog pores and lead to breakouts include oils," she admits. "Though not all oils clog pores, some of the more comedogenic oils include coconut oil and cocoa butter. And while oil-free products are less likely to clog pores, they still have the potential to do so depending on the ingredients."

You can also spot-treat and pamper your acne-prone scalp with your favorite skincare products or masks. Aguilar suggests doing a scalp mask once or twice a week.

"Full-fat non-flavored Greek yogurt can be applied to the scalp after shampooing. Leave it on for ten minutes and the rinse," she says. "Full-fat greek yogurt is naturally rich in probiotics and contains lactic acid. Probiotics help to regulate bad bacteria, and lactic acid is a gentle and natural exfoliant."

She also strongly recommends Biologique Recherche's Masque Bain de Plantes, a plant-based mask with ingredients that help regulate the rate of sebum production and purify skin and scalp. To help speed up recovery from scalp blemishes, you can even apply your favorite acne treatment serum directly to the scalp. Isla Beauty's Storm Serum and Skin1004 Madagascar Centella Ampoule have worked wonders for my acne in the past.

The Bottom Line

Ultimately, scalp care isn't so dissimilar to skin care — but it requires some experimentation, some failure, a careful curation of products, and plenty of consistency to see the results. No one likes to hear that it could take months to see some meaningful progress with your scalp acne, and everyone's journey will be different. But if it means never having to sleep on another weeping and achy bump at night again, or wince whenever I absentmindedly brush my hair and a bristle scratches an angry pimple? I'd be willing to practice a little patience.

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