Scalp acne: pimples, blackheads and whiteheads

Scalp acne is acne on the skin under your hair: whiteheads, blackheads and red pimples that you can often feel with your fingers before you can see them. It forms the same way as acne on the face, and some of its causes are specific to the scalp, such as oily hair products, sweat under a hat, and bumps that look like acne but have a different cause. This guide covers what causes pimples on the scalp, why popping them is a bad idea, which washes and shampoos can help, and when to see a doctor. It is part of Skinli's guide to body acne.

Skinli gives general education. If scalp bumps hurt, keep coming back, or come with bald patches, see a dermatologist.

Why pimples form on the scalp

The scalp has hair follicles and oil glands, like the skin of the face. The American Academy of Dermatology (AAD) explains that whiteheads and blackheads "appear when pores become clogged with excess oil, bacteria, and dead skin cells." When that clog pushes deeper and the skin around it swells, it becomes a red pimple.

Several things add oil, sweat or rubbing to the scalp and make clogged pores more likely.

Hair products

The AAD says "shampoos, conditioners, and styling products can cause whiteheads and other types of acne." The reason is the oil in them: "When hair care products contain oil, the oil can find its way to your skin. Once this happens, the oil can clog your pores." It names the hairline, the upper forehead and the back of the neck as the places where this acne shows. The page names no other part of the scalp, and Skinli found no study of hair products as a cause of acne under the hair. So treat your hair products as a cause to test.

The AAD's page on acne causes lists "oily hair care products, such as pomade" among the things that make acne worse.

If you also get bumps on your back or shoulders, the same products may be the cause there. Skinli's guide to shampoo, conditioner and back acne covers that link and how to test your products one at a time.

Sweat and hats

The AAD's page on workouts says "working out can cause excessive sweating, as well as a buildup of oil, dirt, and bacteria on your skin," and that all of these can lead to acne. On the head, a cap, helmet or headband holds that sweat against the scalp. The AAD also says residue from hair products "can stick to just about anything," and lists caps, hats, headbands, visors, pillowcases and sheets as things to wash. Skinli's guide to sweat and body acne covers what the research on sweat shows.

Stress

The AAD says "stress cannot cause acne," and that "stress may worsen existing acne." So stress can explain why scalp acne flares in a hard month, while the causes you can change are the products, sweat and fabric that touch your head.

Blackheads and whiteheads on the scalp

Blackheads and whiteheads are both clogged pores. The difference is whether the pore stays open.

Spot	What it is	What it looks like
Whitehead	A clogged pore that has closed over	A small bump, usually the color of your skin, sometimes with white pus
Blackhead	A clogged pore that stays open	A black or brown dot, usually flat
Papule	A clog that has pushed deeper and swollen	A small red bump that feels hard
Pustule	A papule that holds fluid	A red bump with a yellow or white center

The descriptions come from the NHS and the AAD. On blackheads, the AAD says: "The black dots aren't dirt, so resist scrubbing. It will only worsen your acne." On the scalp that means no hard scratching with nails or a stiff brush.

Hair covers the scalp, so blackheads there are hard to see, and you may only feel a small rough spot. Skinli's guide to blackheads and whiteheads explains the two in more depth.

Bumps that look like scalp acne

Some scalp bumps have a cause other than acne. Three are worth knowing.

Folliculitis. This is an infection or inflammation of the hair follicles. The AAD says it "usually looks like a sudden acne breakout. Each spot may have a red ring around it, which is a sign of the infection." It may itch, hurt, or cause no feeling at all. Common causes on the AAD's list include shaving, tight equipment, and "medication applied to the skin, such as coal tar," which is an ingredient in some dandruff shampoos. A 2025 review names the scalp as a usual place for bacterial folliculitis. Skinli's guide to folliculitis or acne compares the two in detail.

Acne keloidalis nuchae. The AAD calls this "a common skin condition, which is often mistaken for acne or razor bumps on the back of the neck and scalp." It is most common in Black men and often starts between 14 and 25 years of age. The AAD describes an itch that "may develop hours or days after wearing a helmet or getting a close-shave haircut," followed by small, itchy bumps on the neck, the back of the head, or both. Without treatment, the bumps can turn into scars that cause permanent hair loss. The AAD says self-care alone cannot treat it and advises skipping home remedies, including acids rubbed on the head, which can burn the skin. Skinli's guide to acne on the back of the neck covers it further.

Dandruff and seborrheic dermatitis. The NHS describes dandruff as white flakes of skin on the scalp and in the hair. It can itch, and flaky, red, greasy patches can be seborrheic dermatitis. These cause flakes and patches more than separate pimples. The AAD says a dermatologist can tell whether flaking is a sign of seborrheic dermatitis, psoriasis or a fungal infection of the scalp.

If you cannot tell which of these you have, that is normal. The AAD says a dermatologist can tell folliculitis from acne, and can tell acne keloidalis nuchae from acne or razor bumps.

Popping pimples on the scalp

The AAD's advice on popping is plain: "If you push some of the contents inside the pimple deeper into the skin, which often happens, you increase inflammation." It adds that popping at home risks acne scars, pain, and infection "from the bacteria on your hands."

The scalp adds its own problems. You cannot see the spot, and hair makes the opened skin hard to keep clean. Scratching bumps on the back of the head can also infect them, the AAD says in its advice on acne keloidalis nuchae.

What to do instead:

1. Leave it alone. The AAD says touching, picking and popping can make acne worse.
2. Use ice for a painful spot. The AAD says ice eases pain and reduces swelling.
3. Treat the whole area, and give treatment time.
4. See a dermatologist for a large or painful lump. Dermatologists can clean out blackheads and whiteheads with sterile tools, inject a painful cyst, or drain a large pimple safely.

If you already popped one, keep the spot clean and let it heal. Skinli's guide on what to do after popping a pimple gives the steps.

What can help

Check your hair products

The AAD's test for product acne works on the scalp too:

1. Stop the product you suspect. If nothing stands out, stop products whose labels do not say "won't clog pores," "oil free," "non-comedogenic" or "non-acnegenic." Non-comedogenic means made so it does not clog pores.
2. Wash everything your head touches: pillowcases, sheets, caps, hats, headbands and visors.
3. Wait. The AAD says acne from hair products can take 4 to 6 weeks to clear after you stop, and "you should see clearing within 6 weeks."

Wash after sweating

Wash your hair after exercise or after a day under a helmet or hat. The AAD's workout advice also asks for a towel "that has been washed since you (or someone else) last used it."

Benzoyl peroxide wash on the scalp

Benzoyl peroxide kills acne bacteria. The AAD suggests "a gentle, foaming benzoyl peroxide wash" for acne keloidalis nuchae, and says most patients keep that condition stable when they "wash the back of their neck and scalp with a gentle cleanser that contains benzoyl peroxide." For whiteheads and blackheads in general, it suggests a benzoyl peroxide wash to reduce acne bacteria on the skin.

The US rule for nonprescription acne products allows benzoyl peroxide from 2.5 to 10 percent. It requires the label to warn users to "avoid contact with hair and dyed fabrics, which may be bleached by this product." On the scalp the wash touches your hair every time you use it. Rinse the wash out well, and use white towels and pillowcases. Skinli's guide to whether benzoyl peroxide bleaches covers fabric and hair in more depth.

Salicylic acid and dandruff shampoos

The AAD lists these ingredients for dandruff shampoos: zinc pyrithione, salicylic acid, sulfur, selenium sulfide, ketoconazole and coal tar. The US rule for dandruff products allows salicylic acid at 1.8 to 3 percent in those shampoos. The AAD adds that some dandruff shampoos need to sit on the scalp for up to 5 to 10 minutes before you rinse, so follow the label.

These shampoos treat dandruff. Skinli found no top-tier guideline that recommends a dandruff shampoo for scalp acne. If your bumps itch, look alike, and come with flakes, a doctor can check for a yeast or skin condition that these shampoos treat.

Give it time

Acne treatment is slow. The AAD advises using a product for 6 to 8 weeks before judging it, and says full clearing takes 3 to 4 months. Skinli's own plan for facial acne expects change in 8 to 12 weeks. Skinli's plan covers the face with adapalene 0.1 percent and benzoyl peroxide 2.5 percent. Skinli has no plan for the scalp, and no source it found tested adapalene gel under the hair.

When to see a doctor

See a dermatologist or a family doctor if:

• The bumps are deep, painful or leave scars.
• You have bald patches, or bumps on the back of the head that turn firm or grow. That can be acne keloidalis nuchae, and the AAD says early treatment gives better results.
• The bumps appeared suddenly with a red ring around each one, which can point to folliculitis. Some people need an antibiotic to clear it, the AAD says.
• Your symptoms keep coming back, get worse, or last longer than 2 or 3 days after home care, the points at which MedlinePlus advises contacting a doctor about folliculitis.
• You still have flakes after 4 weeks of dandruff shampoo, the point at which the NHS says to see a GP.
• Nothing has changed after 6 to 8 weeks of treatment.

A doctor can look at the bumps, take a swab if one looks infected, and give prescription treatment where needed.

For acne on the face, Skinli's free acne plan builds a routine from a photo.