Table of ContentsView AllTable of ContentsSymptomsCausesWhat Else Could It Be?Pop or Not?Self-CareNext Steps
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
What Else Could It Be?
Pop or Not?
Self-Care
Next Steps
An occasional painful scalp pimple can form due to a clogged pore or inflamed hair follicle, but multiple or chronic painful scalp pimples may signal a different problem.
Scalpfolliculitis, also known as acne necrotica miliaris orPropionibacteriumfolliculitis, is an inflammatory condition that causes small pustules (pimples that contain a yellowish fluid). They often occur on the frontal hairline, can be itchy or sore, and often become crusted.
Acne keloidalis nuchae(AKN) is a skin condition that causes bumps on the back of the neck andscalpthat are often mistaken forrazor bumpsor acne. Left untreated, AKN can cause raised scars and hair loss.
This article will discuss these causes of scalp pimples, other possible causes, how these conditions are treated, and what to do if they don’t go away.
Soumen Hazra / Getty Images
How Do Scalp Pimples Feel and Look?
Acne cosmetica causeswhiteheadsand papules (small, flesh-colored bumps) along the hairline, forehead, or back of the head.
Folliculitis starts with an area near a strand of hair thatbecomes redand may itch, burn, or be tender.A pustule can then form in the hair follicle that may drainpusor blood.
Without treatment, the bumps can join together to cause a large, raised scar that can be painful.
Chronic Acne Keloidalis Nuchae: How to Manage It Long Term
Causes of Scalp Pimples
Acne cosmetica, scalp folliculitis, and acne keloidalis nuchae are both conditions that can cause pimple-like bumps on the scalp.
Acne Cosmetica
The oil from these products can clog pores and lead to acne.
Scalp Folliculitis
Scalp folliculitis occurs when hair follicles (the openings in the skin that hold the hair root) on the scalp become clogged, causinginfection.
Reproduced with permission from © DermNet and © Raimo Suhonenwww.dermnetnz.org2023.
Folliculitis is believed to be an inflammatory response to microorganisms in the hair follicle, such as:
Folliculitis can also occur after an injury to the hair follicle or irritation, including from:
A 2014 study found that chronic scalp folliculitis may be associated withacne vulgaris(the common form of acne).
Acne Keloidalis Nuchae
AKN causesacne-like breakoutson the back of the neck or head due to long-term inflammation inside the hair follicles. This inflammation weakens the hair follicles, which can cause hairs to penetrate and burrow into the skin (ingrown hairs).
AKN is most common in Black males and generally begins between ages 14 and 25.Without treatment, AKN can cause scars to cover the hair follicle, which can lead to permanent hair loss.
Abscesses (swollen, pus-containing areas under the skin) can develop and may grow together to form sinus tracts (tunnels under the skin). Abscesses and sinus tracts can leakfoul-smelling fluid.
The exact reason that theinflammationdevelops is not known, but possible risk factors incluide:
Causes of irritation on the back of the neck or scalp may include:
When Could Scalp Pimples Be Something Else?
Less common forms of scalp folliculitis include:
Acne Necrotica
Acne necrotica, also calledacne varioliformisoracne frontalis, is a more severe form of scalp folliculitis. It causes largerfollicular spotsthat become inflamed, developblackened crusts, and leave permanent scars. It can affect the scalp, face, and other areas.
Perifolliculitis Capitis Abscedens et Suffodiens
Another severe form of scalp folliculitis is perifolliculitis capitis abscedens et suffodiens, also called dissecting cellulitis/folliculitis, orperifolliculitis capitis. This rare condition causes large nodules andcyststhat contain pus alongside smaller follicular papules (raised spots) and pustules.
Folliculitis Decalvans
Folliculitis decalvans may cause red, itchy, swollen, and/or painful areas on the scalp that can scab and crust. Pus-filled spots can also occur. Folliculitis decalvans is very rare.
Scalp Pimples and Hair LossWithout proper treatment, AKN can cause scarring that leads tohair loss. The scars can also cause ingrown hairs or tufted hairs (several hairs growing out of one hair follicle) to occur near the edge of the scars.Folliculitis decalvans can also cause hair loss due to scarring. It can also cause “corn stalking” (grouped hairs growing within a patch of hair loss).
Scalp Pimples and Hair Loss
Without proper treatment, AKN can cause scarring that leads tohair loss. The scars can also cause ingrown hairs or tufted hairs (several hairs growing out of one hair follicle) to occur near the edge of the scars.Folliculitis decalvans can also cause hair loss due to scarring. It can also cause “corn stalking” (grouped hairs growing within a patch of hair loss).
Without proper treatment, AKN can cause scarring that leads tohair loss. The scars can also cause ingrown hairs or tufted hairs (several hairs growing out of one hair follicle) to occur near the edge of the scars.
Folliculitis decalvans can also cause hair loss due to scarring. It can also cause “corn stalking” (grouped hairs growing within a patch of hair loss).
To Pop or Not to Pop Scalp Pimples?
While it’s tempting to pop pustules, it’s best to leave them be or leave it to a healthcare provider like a dermatologist.
Popping pimplesand blemishes can lead to problems such as:
Self-Care to Get Rid of Scalp Pimples
Acne cosmetica typically clears up within six weeks of discontinuing the product that is causing it. Make sure to also wash the residue of the product from anything your head touched, such as bedding, hats, and other headgear.
If you aren’t sure which product is causing your symptoms, check the labels and stop using any products whose labels don’t have one or more of the following claims:
Along with medication, self-care can help folliculitis to heal. Home care for scalp folliculitis may include:
AKN needs medical treatment and cannot be treated effectively with self-care alone. Self-care may help when used alongside medical treatment. This may include:
Lifestyle Habits to Support a Healthy ScalpTo help maintain ahealthy scalp and hair:Wash your hair regularly.Remove dirt, oil, and residue with soap and clean, running water.Use shampoo and conditioner that work for your hair type.Brush your hair regularly to break apartbuildupand prevent tangles.Avoid sharing objects like combs, towels, and other personal items.Wash your hands regularly to avoid spreading infections likeringworm(a fungal infection).
Lifestyle Habits to Support a Healthy Scalp
To help maintain ahealthy scalp and hair:Wash your hair regularly.Remove dirt, oil, and residue with soap and clean, running water.Use shampoo and conditioner that work for your hair type.Brush your hair regularly to break apartbuildupand prevent tangles.Avoid sharing objects like combs, towels, and other personal items.Wash your hands regularly to avoid spreading infections likeringworm(a fungal infection).
To help maintain ahealthy scalp and hair:
The Next Step: Scalp Pimples That Won’t Go Away
Scalp folliculitis may need to be treated with medication.
Topical medications may include:
Oral medications may include:
AKN does not currently have a cure, but symptoms can be managed, and treatment can help prevent the condition from worsening.
Medical treatment for AKN may include:
When to Call a Healthcare Provider
Contact a healthcare provider if you have:
Summary
AKN requires medical treatment, such as using medicated products, topical or oral medications (including corticosteroids, retinoids, or antibiotics), and surgery.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology Association.Are your hair care products causing breakouts?DermNet.Scalp folliculitis.American Academy of Dermatology Association.Acne keloidalis nuchae: overview.MyHealth Alberta.Folliculitis: care instructions.Cedars-Sinai.Folliculitis, boils, and carbuncles.Children’s Wisconsin.Folliculitis of the scalp.Healthdirect Australia.Folliculitis.Sharquie KE.Chronic scalp folliculitis versus acne vulgaris (Observational case series study). J Clin Exp Dermatol Res. 2014;3(3). doi:10.4172/2155-9554.1000153British Association of Dermatologists.Folliculitis decalvans.MedlinePlus.Folliculitis - decalvans on the scalp.American Academy of Dermatology Association.Pimple popping: why only a dermatologist should do it.Centers for Disease Control and Prevention.Hair and scalp hygiene.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology Association.Are your hair care products causing breakouts?DermNet.Scalp folliculitis.American Academy of Dermatology Association.Acne keloidalis nuchae: overview.MyHealth Alberta.Folliculitis: care instructions.Cedars-Sinai.Folliculitis, boils, and carbuncles.Children’s Wisconsin.Folliculitis of the scalp.Healthdirect Australia.Folliculitis.Sharquie KE.Chronic scalp folliculitis versus acne vulgaris (Observational case series study). J Clin Exp Dermatol Res. 2014;3(3). doi:10.4172/2155-9554.1000153British Association of Dermatologists.Folliculitis decalvans.MedlinePlus.Folliculitis - decalvans on the scalp.American Academy of Dermatology Association.Pimple popping: why only a dermatologist should do it.Centers for Disease Control and Prevention.Hair and scalp hygiene.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Dermatology Association.Are your hair care products causing breakouts?DermNet.Scalp folliculitis.American Academy of Dermatology Association.Acne keloidalis nuchae: overview.MyHealth Alberta.Folliculitis: care instructions.Cedars-Sinai.Folliculitis, boils, and carbuncles.Children’s Wisconsin.Folliculitis of the scalp.Healthdirect Australia.Folliculitis.Sharquie KE.Chronic scalp folliculitis versus acne vulgaris (Observational case series study). J Clin Exp Dermatol Res. 2014;3(3). doi:10.4172/2155-9554.1000153British Association of Dermatologists.Folliculitis decalvans.MedlinePlus.Folliculitis - decalvans on the scalp.American Academy of Dermatology Association.Pimple popping: why only a dermatologist should do it.Centers for Disease Control and Prevention.Hair and scalp hygiene.
American Academy of Dermatology Association.Are your hair care products causing breakouts?
DermNet.Scalp folliculitis.
American Academy of Dermatology Association.Acne keloidalis nuchae: overview.
MyHealth Alberta.Folliculitis: care instructions.
Cedars-Sinai.Folliculitis, boils, and carbuncles.
Children’s Wisconsin.Folliculitis of the scalp.
Healthdirect Australia.Folliculitis.
Sharquie KE.Chronic scalp folliculitis versus acne vulgaris (Observational case series study). J Clin Exp Dermatol Res. 2014;3(3). doi:10.4172/2155-9554.1000153
British Association of Dermatologists.Folliculitis decalvans.
MedlinePlus.Folliculitis - decalvans on the scalp.
American Academy of Dermatology Association.Pimple popping: why only a dermatologist should do it.
Centers for Disease Control and Prevention.Hair and scalp hygiene.
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