How to identify, treat and prevent scalp acne, according to a dermatologist

“Pimples on your scalp occur when hair follicles become blocked with oil and dead skin cells, or bacteria, and subsequently become inflamed or infected,” explains Anabel. “You have a lot of oil glands on your scalp – there is one at the base of every hair follicle, so it is not unusual for a few spots to form. However, if you have many spots on your scalp, and they are angry, painful and inflamed, you should seek help from a doctor or trichologist.”

Not to be confused with other scalp conditions, Dr Nora outlines the differences and what to look out for if you think you might have scalp acne. “Scalp acne or folliculitis typically presents as small red bumps or pustules centred around hair follicles, often with tenderness or itching,” she says. “Conditions such as psoriasis tend to cause thicker plaques with silvery scaling, while seborrhoeic dermatitis usually presents with flaking, redness, and greasy yellowish scale rather than individual spots.”

According to Anabel, it’s pretty normal to get a few pimples on your scalp once in a while. “You may find their formation correlates with hormonal changes, like menstruation.” Just like the skin on your face, your scalp can get a bit cranky and spotty leading up to your period. “This is because oil secretion can increase, which increases the likelihood of blocked pores.”

Just like facial acne, often oil-based products like heavy pomades can cause clogging of the pores or glands, which means you really need to look at the ingredients in your hair products and choose formulas that won't cause excess oil build-up.

As well as fluctuating hormones, there are a vast number of other potential causes to be aware of. These include:

“PCOS can raise your androgen (male hormone) levels. An excess of male hormones can increase sebum production on the scalp,” says Anabel.

“Certain birth control pills are ‘androgenic’, and can therefore increase oil production,” explains Anabel.

“Pimples often accompany the skin flaking and oiliness of dandruff and seborrheic dermatitis,” says Anabel.

READ MORE: The best shampoo for dry scalp.

“Like your face, the scalp is a very sebaceous environment. The scalp can become overly greasy if you do not shampoo often enough, making it more prone to breaking out,” says Anabel. “Bacteria (specifically staphylococcus aureus) naturally live in your nose and is harmless. However, if you pick your nose and then scratch your scalp, you can transfer staph bacteria onto your scalp, which may cause inflammation and pimples.”

A skin condition that looks very similar to the common pimple, but the spots are usually itchier, smaller and in larger clusters. “Folliculitis is often caused by bacterial infection, acne or fungal infection. Some people are more prone to it than others, but it is more likely to occur when your scalp is overly greasy; fungi love an oily environment,” says Anabel.

At opposite ends of the spectrum, but over and underwashing hair can lead to scalp acne. “Underwashing allows oil, sweat and product residue to accumulate, increasing the likelihood of follicle blockage, while overwashing with harsh shampoos can irritate the scalp barrier, triggering inflammation,” explains Dr Nora. “Heavy styling products, oils and waxes applied directly to the scalp can also contribute to congestion.”

Just like acne, picking pimples on your scalp will only make things worse and actually cause more trauma to the skin, further inflammation and maybe even scarring. “If you pick at pimples, scars can form which will prevent the growth of hairs in the scarred areas,” says Anabel.

It can further inflame and irritate your scalp.

“You do not want to repeatedly run a brush over your scalp as this can scratch and further irritate pimples,” warns Anabel.

Dermatologist Neal Schultz advises to keep hair repair treatments and deep conditioning masks to the ends rather than the roots since most people with acne or severe dandruff suffer from an excess of oil on the scalp. “You don’t want to feed fuel to the fire; you don't want to put oil on acne,” Schultz says.

Here are our top tips.

“Use a daily soothing anti-microbial shampoo and a daily astringent, anti-microbial scalp toner (an astringent is an ingredient that helps to soak-up excess oils),” advises Anabel. Choose ones with ingredients such as witch hazel (an astringent), piroctone olamine (anti-bacterial) and camphor (soothing).” Try Philip Kingsley Itchy Flaky Scalp Shampoo and Toner for a targeted treatment using the best ingredients.

Dr Nora suggests also looking for products that include salicylic acid. “We want ingredients that address build-up, inflammation and microbial imbalance around hair follicles,” she says. “Ingredients such as salicylic acid can help exfoliate and unclog follicles, while soothing scalp actives can calm inflammation and reduce itching and irritation. Formulations designed specifically for scalp health, such as Neutrogena T/Gel Anti-Dandruff Sensitive Scalp Shampoo, work by cleansing away debris and excess oil while helping soothe scalp irritation, which can reduce the environment that contributes to follicular congestion and breakouts.”

“I also suggest you use a twice-weekly targeted scalp mask containing salicylic, lactic and hyaluronic acid which work together to exfoliate, cleanse and soothe, such as the Philip Kingsley Flaky/Itchy Scalp Mask.”

If over-the-counter remedies do not work, visit your doctor or trichologist as you may need prescription strength treatments.

Here, we've got two main pieces of advice.

Try using it a few times a month. The experts recommend preventing oil and flaky build-up by using a shampoo containing witch hazel or salicylic acid – such as Neutrogena T/Gel Therapeutic Shampoo. Just be sure not to over-use or else you might end up drying your scalp out. “Maintaining a healthy scalp environment is key when managing scalp acne, and targeted scalp shampoos like this can be a useful part of that routine,” explains Dr Nora.

If you feel any bumps appearing, applying tea tree oil directly to your scalp a few hours before washing your hair will help eliminate bacteria and speed up the process of eradicating the pimple.