Scalp Acne: Pimples in Hair & Best Treatment Options

The daily life reality of scalp acne is really just continuous aggravation, causing impairment in your day to day life. Simple activities such as brushing and styling your hair, blow-drying or shampooing causes soreness, while applying styling products aggravates any existing head pimples. Applying basic necessities on your head such as a helmet, hat or even headphones can cause pulsating pain due to pressure as well as making existing acne breakouts flare up.

Aside from the physical daily discomfort of having head pimples, there also is the overall mental and emotional toll scalp acne can have on one’s haircare routine. For those dealing with visible outbreaks that pop up along the hair line may face notable self-consciousness, social withdrawal and low self-esteem. This can create a cycle where anxiety causes the body to release a stressful substance, cortisol, which causes your body to produce more sebum and then exacerbates your pimples on scalp.

Understanding The Anatomy Of The Scalp

Your scalp contains some of the thickest dermis in the body and contains a very high concentration of terminal hair follicles on the scalp itself. Closely associated with these terminal hair follicles lie sebaceous (oil) glands in the form of pilosebaceous units. These glands constantly secrete sebum (a natural oil) that plays a very active role in lubricating the hair shaft and forming a protective barrier around the hair that is also waterproof by forming a barrier over the stratum corneum. If the skin microbiome and barrier health is in perfect balance, then the sebum readily flows from the pore, helping to ensure supple skin and healthy hair.

How Scalp Acne Occurs

It usually occurs following the 4 Main Steps

1.Poor shedding

It is normal practice for old, worn and dead skin cells to shed regularly. When they do not shed properly it leads to pore clogging.

2.Overproduction Of Sebum

A number of influencing factors like hormones, stress, genetic traits, environmental stimuli, etc. can promote and change the quantity and quality of sebum produced and released onto the skin surface. This over produced sebum then mixes with other impurities such as trapped dirt, pollution, dead skin cells, traces of makeup and grime to block the pores.

3.Microbial Attack

This oily occluded sebum along with dirt and dead cells form a kind of breeding ground, an anaerobic situation and a good environment to allow Malassezia furfur (microbes that causes fungal acne) as well as Cutibacterium acnes (microbes causing bacterial acne) to multiply readily.

4.Inflammation

These microbes responsible for acne feed on the trapped sebum and initiate an inflammatory response from your immune system that fights against the overabundance of microbes contributing to acne and irritation on your skin barrier. This subsequently results in the formation of cluster red, swollen, pus filled acne spots under your hair

Common Skin Disorders Associated With The Scalp Which May Be Identically Confusing

Scalp Acne

Scalp acne or acne vulgaris is essentially a blocked pore which is then inflamed by bacterial overgrowth leading to acne. This can present as blackheads, whiteheads, papules, pustules, nodules and even extremely painful cysts. This condition is the result of lack of shedding and excess production of sebum.

Scalp folliculitis

Scalp folliculitis is basically the infection of the hair follicle. It is characterized by small and red, the same size red bumps often appearing in groups about hair shafts and small white pustules on the head of the bump. They can be intensely itchy/burning. Normally due to inflammatory bacterial infection (the most common cause being Staphylococcus aureus) or fungus growing in a damaged hair follicle due to scratching, shaving or friction.

Scalp Psoriasis

Psoriasis is a chronic, autoimmune disease of the skin which drastically speeds up the shedding of cells and often manifests with reddish patches and silvery-white scales with itchy scalp.

Seborrheic dermatitis

This is one of the commonest and most chronic conditions causing flaking, it's often mistakenly described as severe dandruff. Inflammatory, this condition is thought to be caused by excessive reproduction of a type of yeast known as Malassezia. At its most elementary form, its presentation is greasy skin which is very itchy and has a yellowish scale, but can also affect the head with an inflammatory eruption of small, reddened and inflamed papules from the scalp up the sides of the face along the hairline.

Scarring alopecia

Hair falls out permanently and thin out locally with increased itchiness while the tissue is replaced by scar tissue of the scalp.

Pityrosporum folliculitis

Inflammation of the hair follicles on the scalp which is actually caused by an overgrowth of a fungus called Malassezia furfur.

Note

Consult a dermatologist for the precise diagnosis of the inflamed breakouts on the scalp and suitable recommendations for the scalp acne treatment in a personalized manner for proper prevention as well as management of the scalp acne.

The Role Of A Dedicated Acne Care Routine For The Skin

The scalp acne may also lead to the other secondary infection around the neighbouring areas like hairline, forehead, temple and neck. You should use a dedicated acne care range for those areas so as to prevent and manage the secondary infection on the skin around the scalp and hair. You can use the targeted anti-acne skincare regimen by Alite Skincare that includes

The Key Triggers Of Scalp Acne And Their Management

Sr. No.	Key Trigger	Management
1.	Hair Cosmetics	Excessively occlusive and greasy haircare can seal the follicle openings leading to the sealing of follicular and natural sebum pathways of scalp and hair, thereby encouraging the breakout of acne lesions on the scalp. It is also known as acne cosmetica. Hence, you should go for non-comedogenic haircare and scalp care products with a high safety profile of the composition. You must ensure clearing off cosmetic buildup regularly to combat scalp acne.
2.	Friction	The excessive friction from items of everyday use such as helmets, firm headbands, work clothes, etc. can cause the lesions known as 'acne mechanica' on the scalp. Acne Mechanica is caused by a combination of physical friction and local occlusion. Wearers, by virtue of their everyday use, inadvertently spread an accumulation of sweat, dirt and sebum over the surface of the scalp. A firmly worn head gear will cause the accumulated buildup to be physically pressed down into the hair follicles. The warm humid micro climate, which forms underneath a worn head gear, also provides a growth incubator for various bacteria and fungi. You should clean the head gear before using it at every stage. Don't wear a firm head gear for an extended duration of time.
3.	Improper Hair Cleansing Routine	If you skip washing your scalp and hair over time, you effectively pile up days of sweat, sebum, toxins and dead skin on your scalp, leaving them to accumulate firmly and set deeply within the pores. Too much harsh or heavy foaming shampoo may wash away the crucial natural moisturizing barrier on the scalp. This results in the severe drying and the overzealous glands secrete way too much oil, making the already clogged pore walls to stretch, leaving larger looking pores, inflamed skin and acne. Use effective and natural cleaners for your skin which not only consist of acne fighting actives but also take good care to repair damaged skin barrier.
4.	Hormonal Triggers	The skin on your scalp tends to have a substantial number of pilosebaceous units. These are particularly responsive to changes in the body's biochemistry. An increased secretion in specific circulating hormone levels such as androgen (which is both the male hormone in male and female body) cause increased production of greater quantity of thick and viscous sebum through its interaction with sebaceous glands. This usually occurs due to effects of hormonal balance such as changes occurring during puberty, menstrual cycles, pregnancy, peri-menopause and periods of chronic high stress levels. Visit a doctor to have your hormonal levels identified that may be influencing scalp acne.
5.	Dietary Factors	It also often includes a low-nutrient, high-glycemic (or high sugar) diet of food like refined sugar, white bread and other packaged snacks that promote insulin sensitivity and an overall increase in the body’s inflammation system. Eat foods with low glycemic load and plenty of rich vitamin and mineral diet for better skin health.
6.	Environmental Stress	Excessive sun exposure on the skin in the damaging and skin damaging UV rays, can cause the skin and scalp to be under stress through oxidation with higher free oxygen radical output, also the high and humid weather may also affect sebum and sweat secretion on the skin. The environment that is surrounded with pollutants such as dirt, heavy metals and smoke can trap onto the skin that is oily acne prone with sticky sebum and skin cells. This literally clogs up the pores on the scalp so that the active acne on the scalp becomes aggravated. Use non-comedogenic thermal protectant hair products for scalp and hair.

Points To Consider

In dealing with scalp acne, you must maintain a prudent, consistent as well as disciplined approach. You should not behave aggressively with breakouts. Excessive scrubbing of the scalp, popping the pimples or using multiple harsh products on your scalp in a single session can damage the natural barrier of your scalp, worsen the inflammation and increase the risk of leaving you post-inflammatory hyperpigmentation marks or even causing a bacterial infection. Consistent and mild treatment of the scalp works better than harsh and infrequent treatment. For thick, long or frequently oil/serum/dry shampoo-applied hair, also pay closer attention to product buildup on the scalp by the root that may gradually worsen congestion in a hidden manner.

In addition, hygiene methods that individuals rarely focus on are also important to consider. Towels, combs, brushes, helmet liner/cap, towel, hairbands may all absorb the moisture of hair and dead skin cells. By repeatedly using them, you might always be exposed to the impurities triggering an outbreak on the skin of the scalp. After heavy physical exercise or in a hot and humid environment, thoroughly cleaning your hair helps effectively avert the chances of clogging hair follicles and overgrowing of microorganisms on skin.

Another important point is that we must be clear that not every pimple on the scalp can be termed acne, it could be scalp folliculitis, seborrheic dermatitis, psoriasis or tinea. They may have alternative care pathways. It is also obvious that the acne on the scalp is highly sensitive and purulent, rapidly increasing and related with hair fall. Without significant improvement with typical acne care, evaluation by a specialized physician would become crucial for timely interruption of excessive inflammation and repetitive outbreaks and prevent scarred cases too if more severe inflammation were identified. Use the targeted anti-acne skincare products on a daily basis to prevent the secondary infections associated with scalp acne such as neck acne, forehead acne, etc.

Last but not the least, patiently managing and treating your acne on the scalp is required for effective improvement, given the complexities of hormonal imbalance, stress, friction and improperly selected products. Consistency in scalpcare, selective non-comedogenic formula, maintained internal well-being as well as timely help of dermatologist could make you relieved and become confident to style your hair however you like.