Persistent Scalp Acne for Over 6 Months: Effective Treatment Options

If you have been experiencing persistent scalp acne for over six months, it is advisable to consult a dermatologist. They can evaluate your condition and recommend appropriate treatments, which may include topical or oral medications, medicated shampoos, or lifestyle changes to help manage and reduce the acne?

I frequently develop 4 to 5 pimples on my scalp, and this has been ongoing for six months.
Even during this winter in March, when I wasn't sweating, they continued to appear without improvement.
They are painful to the touch, and if they rupture, they ooze pus and blood.
Occasionally, I also get pimples on my face, particularly in the T-zone, which is oily skin, but I only have 1 to 2 on my face at most, significantly fewer than on my scalp.
I cook my own meals, do not stay up late, and regularly clean my pillowcases.
I also have dry eye disease affecting my cornea, which prevents me from taking oral retinoids.
What treatment options do you recommend? Thank you.

Awei, 20~29 year old female. Ask Date: 2020/08/02

Dr. Wu Yuxin reply Dermatology

Without actually seeing the lesion, it is impossible to determine the issue.
If it is causing significant distress, please seek medical attention promptly.
A proper examination is necessary to identify the problem and determine the appropriate course of action.

Reply Date: 2020/08/02

More Info

Persistent scalp acne can be a frustrating and painful condition, especially when it lasts for over six months. Given your description of painful lesions that produce pus and blood when ruptured, it is essential to consider a comprehensive approach to treatment. Here are some effective treatment options and considerations based on your situation.

1. Topical Treatments
Since you cannot take oral isotretinoin due to your dry eye condition, topical treatments may be your best option. Look for over-the-counter products containing ingredients such as:
- Benzoyl Peroxide: This is an antibacterial agent that helps reduce acne-causing bacteria and can also help with inflammation.

- Salicylic Acid: This beta hydroxy acid (BHA) helps exfoliate the skin and unclog pores, making it effective for acne.

- Retinoids: Topical retinoids (like adapalene) can help prevent clogged pores and promote cell turnover. They are generally well-tolerated and can be effective for acne.

2. Antibiotics
If your acne is inflamed and producing pus, a topical antibiotic like clindamycin may be beneficial. This can help reduce bacteria on the skin and decrease inflammation. In some cases, a healthcare provider may prescribe a short course of oral antibiotics if topical treatments are insufficient.

3. Hormonal Treatments
If your acne is linked to hormonal fluctuations, consider discussing hormonal treatments with your healthcare provider. Options may include:
- Oral Contraceptives: Certain birth control pills can help regulate hormones that contribute to acne.

- Spironolactone: This medication can help reduce oil production and is often used for hormonal acne in women.

4. Lifestyle Modifications
While you mentioned that you maintain a healthy lifestyle, consider the following adjustments:
- Diet: Some studies suggest that high-glycemic foods and dairy may exacerbate acne. Consider reducing these in your diet and focusing on whole foods, fruits, and vegetables.

- Stress Management: Stress can worsen acne, so incorporating stress-reducing activities like yoga, meditation, or regular exercise may help.

5. Professional Treatments
If over-the-counter and prescription treatments do not provide relief, consider consulting a dermatologist for professional treatments, such as:
- Chemical Peels: These can help exfoliate the skin and reduce acne lesions.

- Laser Therapy: Certain laser treatments can target acne and reduce inflammation.

- Extraction: A dermatologist can safely extract cysts or lesions that are painful and not responding to other treatments.

6. Regular Follow-ups
Given the chronic nature of your scalp acne, regular follow-ups with a dermatologist are crucial. They can monitor your condition, adjust treatments as necessary, and ensure that you are on the most effective regimen for your specific needs.

Conclusion
Persistent scalp acne can be challenging to manage, especially with your existing dry eye condition limiting certain treatment options. However, a combination of topical treatments, potential antibiotics, hormonal therapies, lifestyle modifications, and professional interventions can significantly improve your situation. Always consult with a healthcare professional before starting any new treatment to ensure it is appropriate for your specific health needs.

Similar Q&A

Persistent Scalp Acne: Causes, Treatments, and Solutions

Since around February of last year, I have been experiencing frequent breakouts on my scalp. During severe episodes, my scalp becomes red, swollen, and pus-filled. After consulting with doctors and taking medication, the condition keeps recurring, and it has been nearly a year no...

Dr. Wu Yuxin reply Dermatology
Please seek medical attention as soon as possible. An examination is necessary to determine the issue and to be able to address it properly.

Persistent Acne: Seeking Solutions for Long-Term Skin Issues

Hello Dr. Hong, I have been struggling with acne for over 10 years. I have consistently seen doctors, and my lifestyle is quite normal; I do not consume sugary drinks or snacks. I have tried various treatments, including a combination of Western and Chinese medicine, acupuncture...

Dr. Hong Zhengsheng reply Dermatology
Hello Iven: The acne treatment methods approved by the Department of Health have mostly been mentioned in your letter. My personal suggestion is to find a dermatologist you trust and collaborate with them over the long term, as this may be a better treatment approach for you at t...

Dealing with Scalp Acne and Hair Loss: Effective Solutions

I have had acne on my scalp for nearly a year, which may be seborrheic dermatitis. I have seen many doctors, and the only treatment has been antibiotics. When I take them, the acne doesn't appear, but once I stop the medication, it comes back in clusters. Now, there are many...

Dr. Zheng Lizhen reply Dermatology
Based on your description, your issue may be seborrheic dermatitis combined with folliculitis. Please visit a dermatologist for a personal consultation. Seborrheic dermatitis cannot be completely cured, as the underlying causes remain unclear, so definitive treatment is not curre...

Managing Oily Scalp and Acne: Effective Solutions for Seborrheic Dermatitis

I am 21 years old and have been struggling with an oily scalp for many years. I have consulted a doctor who diagnosed me with seborrheic dermatitis and recommended using Renshan Lishu; however, my condition has not improved after using it. Is it true that the problem of an oily s...

Dr. Jiang Zheen reply Dermatology
Dear Michelle: Currently, there are only two main classes of medications known to inhibit sebaceous glands: oral retinoids and oral female hormones. There is still no effective topical medication available; however, if these medications are discontinued, sebaceous gland secretion...