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Acne on My Scalp

Acne on My Scalp Acne on My Scalp


Scalp folliculitis is an inflammatory condition that affects men, women and children. Although "acne on the scalp" and "scalp acne" are common alternative descriptive names for scalp folliculitis, the condition is most closely associated with infection rather than excess oil production in hair follicles, which is a primary contributor to acne.

General Types

Mild scalp folliculitis produces varying amounts of small, extremely itchy pus-filled lesions, or pustules, often along the hairline at the front of the head. Scratching causes the lesions to form crusts and feel sore. Acne necrotica, a severer form of scalp folliculitis, is also called acne frontalis or acne varioliformis. The condition involves large inflamed bumps, or papules, on the scalp that usually do not contain pus. Once inflamed, the lesions form blackish crusts that eventually cause depressed, permanent scars resembling pox marks.

Special Types

Perifolliculitis capitis abscedens et suffodiens, or PCAS--the severest form of scalp folliculitis--is alternatively called perifolliculitis capitis, dissecting cellulitis or dissecting folliculitis. Characterized by large cysts and nodules mixed with smaller pustules and papules, the condition occurs mostly in black men. The lesions are usually located at the back or top of the head, and they may contain pus, accompanied by permanent bald spots and scars. Acne keloidalis nuchae affects people of color primarily and individuals with curly or stiff hair, causing inflamed skin and scarring at the back of the head and neck. People of color who use pomade, a type of oily hair ointment, may develop acne cosmetica, also called pomade acne. The condition produces acne blemishes on the forehead and scalp after they come in contact with pomade, and it affects approximately 3/4 of pomade users, according to the American Academy of Dermatology.


Although the cause of scalp folliculitis, acne necrotica and PCAS remains unclear, according to the New Zealand Dermatological Society, it is linked to inflammation of hair follicles due to various microscopic organisms, such as bacteria, mites and yeast. Acne keloidalis nuchae results from ingrown hairs, which often occur following close-cropped haircuts. Pomade acne develops when pomade obstructs hair follicles, trapping oil, dead skin cells and bacteria that accumulate and produce acne blemishes.


Treatment for mild scalp acne includes washing hair with regular mild shampoo or antifungal shampoos--such as those containing ciclopirox, for example--and using conditioner if necessary. Doctors may also recommend applying topical products containing antibiotics or steroids to affected areas, or taking oral medications, such as antibiotics, antihistamines or the potent acne drug isotretinoin. Although severe scalp folliculitis may resist treatment, options to reduce symptoms include taking antibiotics, dapsone, isotretinoin or injected or oral doses of corticosteroids. Treating acne keloidalis nuchae may involve using antibiotics or injected or topical steroid medications. Lesions that resist conventional treatment may require complete surgical removal, however. Pomade acne usually clears up when individuals stop applying pomade directly to the affected areas.


Pomade use can also cause folliculitis on the head, a bacterial infection distinct from pomade acne. Pomade-related folliculitis produces redness and pus-filled bumps, and it may ultimately spread or cause hair loss. Individuals with suspected pomade-related folliculitis should stop applying pomade and seek medical assistance.

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