Dermatologists recommend the best medicated shampoos to clear up folliculitis and other types of scalp acne
You probably already know that pimples can pop up on places other than your face, but it’s not just your back, chest, and booty that are blemish-prone. The scalp is another spot where zits happen, although using the term “scalp acne” isn’t exactly as straightforward as it may seem.
“Scalp acne refers to breakouts, such as red pimples and pustules, on the scalp. It may result from a build-up of oil and clogged pores, bacteria and inflammation, and can also have a hormonal component,” explains Marisa Garshick, MD, a board-certified dermatologist in New York City. More specifically, p.acnes, the bacteria that causes acne vulgaris—acne, in the traditional sense—can be involved, she says. But, what’s often thought to be or called scalp acne, may actually be folliculitis. This refers to inflammation of the hair follicle, triggered by a different type of bacteria, staphylococcus aureus, notes Brooke Jackson, MD, a board-certified dermatologist in Durham, North Carolina. Here’s what things get confusing: the two often have very similar manifestations—papules, pustules, nodules—so it can be hard to distinguish between the two, she adds. (While it’s not a foolproof method of determining, those who have acne on their face, body, and scalp may be dealing with traditional acne, whereas if it’s just on the scalp, it’s more likely to be folliculitis, says Dr. Garshick.)
To complicate things even further, there’s also a condition known as acne cosmetica, which, according to the American Academy of Dermatology, occurs when ingredients in hair products cause clogged pores that manifest as tiny bumps and pustules1. This most often shows up around the hairline, as well as on the forehead and back of the neck. Regardless, your hair type or texture doesn’t play a role here; those with an oily scalp may be more predisposed to developing scalp acne, but any hair type can experience it, says Dr. Garshick. (To that point, think of using the medicated shampoos below to treat the skin on your scalp, and rotate them with other shampoos that you use for your specific hair type, more on that point in a moment.)
We conducted hours of research on the best medicated shampoos for scalp acne, evaluating each formula on active ingredients and their effectiveness. We also had a look at whether or not the formula contains sulfates, which can be a potential scalp-irritant. After consulting with two board-certified dermatologists, and considering dozens of top-rated brands, we landed on the following best in show.
Best Overall: Neutrogena T/Sal Therapeutic Shampoo With Build-Up Control
Both dermatologists we spoke with include this on their list of top recommendations with Dr. Garshick noting that it’s a particularly good choice for those dealing with both an oily scalp and breakouts. “It contains three-percent salicylic acid, a beta-hydroxy acid exfoliant that gets rid of dead skin cells, unclogs pores and reduces oil. The shampoo can also help reduce itching and dryness, and is helpful for other scalp conditions, including seborrheic dermatitis, psoriasis, and dandruff,” she explains. On top of that, it’s super affordable, too.
Best Drugstore: Raw Sugar Shampoo Scalp Restore Activated Charcoal + Tea Tree + Moringa Oil
The activated charcoal in this formula helps to soak up and remove excess oil, while the tea tree oil is a natural anti-inflammatory and antimicrobial ingredient. It does contain fragrance, but the refreshing, minty-citrusy scent is a crowd pleaser. Just make sure to rinse it out thoroughly, as it does tend to leave behind a bit of a residue.
Best with Salicylic Acid: OUAI Anti-Dandruff Shampoo
Salicylic acid is often recommended for face and body acne, and the same holds true for your scalp; Dr. Garshick says it’s one of the best ingredients to look for because it can both eliminate excess oil and unclog pores. Here, you get a two-percent concentration, but in a shampoo that smells so sophisticated (and a bottle that looks so fancy) you’d never guess it was made for addressing scalp issues.
Best with Tea Tree Oil: OGX Extra Strength Refreshing Scalp + Teatree Mint Shampoo
As far as natural acne-fighters go, tea tree oil easily tops the list, known for its anti-inflammatory and antimicrobial effects. It’s the star of the show here, though there’s also astringent witch hazel in the mix, helping to further balance excess oil production. Bonus points for the invigorating scent and sensation it delivers, both soothing the skin and waking you up, choice for sleepy mornings.
Best for Sensitive Skin: Vanicream Free & Clear Shampoo
Dealing with both sensitive skin and uncomfortable breakouts on your scalp is no fun. Happily, this formula is the perfect option if you have both, says Dr. Garshick. “It’s fragrance-free, sulfate-free, paraben-free, and dye-free, but still helps remove buildup without leaving your hair feeling stripped or scalp irritated,” she says.
Best for Flakes: Jupiter Balancing Dandruff Shampoo
The bad news: Dandruff and scalp breakouts can also go hand-in-hand, as flaking and buildup can contribute to breakouts, says Dr. Garshick. The good news: This shampoo will help nip all of that in the bud. It relies on zinc pyrithione, an anti-dandruff ingredient, though the balancing formula also helps control oil, so although this is a pricier option, it contains a medicated formula. It’s also enjoyable to use, thanks to a scent of mint, vanilla, sage, and lavender, Dr. Garshick points out.
Best for Itching: Dove DermaCare Scalp Anti Dandruff Shampoo
Is there anything more uncomfortable than an itchy scalp? We think not. That’s where this guy comes in, a great choice if you have scalp acne and dandruff (both of which, you guessed it, can be itchy and uncomfortable). “This shampoo helps to improve flaking and reduce itching without leaving the scalp feeling dry or irritated. It contains pyrithione zinc to effectively treat, while also nourishing the scalp,” says Dr. Garshick of another one of her favorites.
Best Exfoliating: The Inkey List Glycolic Acid Exfoliating Scalp Scrub
As is the case with other types of acne, exfoliating can be beneficial…so long as it’s done correctly. Dr. Garshick says glycolic acid is one of the best exfoliating ingredients to seek out, gently yet effectively removing potentially pore-clogging build-up. It’s the star of the show in this formula, which technically isn’t a shampoo, but does work great as a weekly treatment to keep breakouts and flakes at bay.
Best for Color-Treated Hair: John Paul Mitchell Systems Tea Tree Special Shampoo
If you have color-treated hair, medicated shampoos can pose—as a general rule of thumb—a little bit of a tricky conundrum, as many can be too harsh or stripping on your color. While this pick does contain sulfates it is still safe for color-treated hair. Dr. Garshick likes it because it contains tea tree oil, which she says is both anti-inflammatory and has antibacterial properties, both good things if you’re dealing with any kind of breakouts on your scalp. And the minty fresh scent is a nice added bonus.
Best Budget: Sulfur8 Deep Cleaning Shampoo
Dr. Jackson likes this pick, which takes the cake when it comes to great value. Affordable and effective, it relies on benzyl benzoate, an antimicrobial ingredient to help combat pimples and dandruff, too. Just make sure to pair it with a moisturizing conditioner, as it can be fairly stripping, particularly if your hair is on the drier side to begin with.
Best Anti-Fungal: Nizoral Anti-Dandruff Shampoo
Along with all of the different types of scalp “acne” mentioned earlier, there’s also another potential culprit behind the bumps on your scalp. “Pityrosporum folliculitis happens when a yeast that’s naturally-occuring on the skin multiplies and infects the hair follicles,” says Dr. Jackson. You need an anti-fungal ingredient to target that, like the ketoconazole in this shampoo. It’s great for fighting dandruff too, hence the name.
Best for Folliculitis: CLn Healthy Scalp Shampoo
Another pick that came from both of our experts, this is an especially good choice if you’re dealing with folliculitis. Credit sodium hypochlorite in the formula, a do-it-all ingredient that’s antibacterial, antifungal, and anti-inflammatory, yet still super gentle on even sensitive skin. It’s paired with salicylic acid to effectively cleanse, disinfect the scalp, and unclog pores, says Dr. Garhsick, who also lauds it for the addition of hydrating glycerin so that you don’t have to worry about it over-drying your hair or skin.
Best Non-Comedogenic: SEEN Skin-Caring Fragrance-Free Shampoo
To be fair, this doesn’t contain any active ingredients that are going to treat scalp acne, per se, but it also doesn’t have any of the common culprits that will make it worse. Namely, we’re talking about heavy, pore-clogging oils that can contribute to breakouts not only on your scalp, but also on your hairline, forehead, neck, and back.
Best for a Luxe Experience: Oribe Serene Scalp Anti-Dandruff Shampoo
There’s nothing sexy about a medicated shampoo…or is there? This splurge-worthy option may be intended for combating dandruff (although it’s also good for breakouts, thanks to a two-percent concentration of salicylic acid), but using it feels super special and spa-worthy. Everything from the gorgeous pink bottle to the luscious lather to the lovely scent makes it feel like a far cry from most other medicated shampoos out there.
Final Verdict
There are a lot of different things that can cause scalp acne (which really can be one of many things). Still, the Neutrogena T/Sal Therapeutic Shampoo is our overall winner, an affordable drugstore staple that contains salicylic acid, one of the most often derm-recommended ingredients for dealing with scalp breakouts. Speaking of, it’s also the star of the show in the Ouai Anti-Dandruff Shampoo.
What to Look For In a Medicated Shampoo for Acne
Active Ingredients
While some of the winners on our list are more gentle options that are simply meant not to exacerbate scalp acne, if you’re looking for a true treatment-type pick, look for one that contains active ingredients. According to Dr. Garshick, oil-dissolving and pore-unclogging salicylic acid is one of the best. It’s the main ingredient of our best overall pick, Neutrogena T/Sal Therapeutic Shampoo. Garshick also recommends looking for anti-inflammatory and antibacterial tea tree oil, found in OGX Extra Strength Refreshing Scalp+ Tea Tree Mint Shampoo. Finally, exfoliating glycolic acid can help to purge the scalp of clogged pores. Consider The INKEY List Glycolic Acid Exfoliating Scalp Scrub if you’re looking for more of a medicated scalp treatment.
Frequency of Use
As in most cases, your best bet is to follow the directions for the particular product you’re using; many are only meant to be used a few times per week. That being said, as a general rule of thumb, medicated shampoo can be drying, so you can also consider following one with any regular shampoo that you’re using for your particular hair type, notes Dr. Jackson.
No Pore-Clogging Ingredients
Steer clear of heavy oil and other ingredients that can be comedogenic (aka clog pores) in your hair care products, notes. Dr. Garshick. This holds particularly true if your scalp is very oily and your scalp acne is due to excessive oil. However, those with dry scalp may also experience scalp acne, as flakes and scalp acne can often go hand-in-hand. For that, both the Jupiter Balancing Shampoo and the Dove DermaCare Scalp Dryness & Itch Relief Anti-Dandruff Shampoo are top choices.
FAQ
What is scalp acne?
It’s both not really its own thing, and yet, also can be many different things. It can either be acne vulgaris (the kind you’d see on your face or body), folliculitis (an inflammation of the hair follicle cause by a different type of bacteria than acne vulgaris), a type of fungal acne known as pityrosporum folliculitis, or just clogged pores caused by the hair care products you’re using.
How do you get rid of scalp acne?
You can try using an over-the-counter medicated shampoo but, if you have pimples that aren’t resolving or deeper cysts or nodules, it’s important to see a dermatologist, Dr. Garshick advises. Not only can it be hard to determine the type of scalp “acne” you have, there are other more serious conditions that can also have similar symptoms and require medical treatment.
Can scalp acne lead to hair loss?
According to Dr. Garshick, it’s not typical, although she is quick to note that some of those aforementioned conditions that may look the same can be associated with scarring hair loss, which is why it’s so important to be evaluated by a derm. And Dr. Jackson points out that folliculitis that’s left unchecked can lead to hair loss as a result of chronic inflammation.
