Dandruff is a common condition resulting dry and flaking of the skin on the head (scalp) and can affect any age group or gender.Apart from itching and shedding skin flakes, dandruff can usually be accompanied with pimples on the head (scalp pimples). Scalp pimples are usually caused by inflammation and sometimes infection of the hair follicle (folliculitis) characterized by itchy pustules on the affected area. These pimples usually dry up spontaneously and form a crust on the scalp. While scalp pimples may subside without any treatment, it can become a serious condition if the infection spreads.

What are Scalp Pimples?

Pimples on the head are caused by microorganisms such as yeasts (malassezia), a form of skin fungus, mites, or bacteria. These microorganisms thrive on the dead cells of the outer layers of the scalp resulting in the outbreak of pimples. Yeasts, such as malassezia (Pityosporum ovale) often live on the scalp of healthy individuals causing no harm to the host but due to aggravating factors, like a hair dye allergy or seborrheic dermatitis, the yeast tends to grow out of control as it feeds on the dead skin cells. The hair follicle becomes inflamed and irritated. The irritation results in the skin shedding further. The dead skin cells clump up with the oil in the scalp and eventually fall off. Fatty acids are also produced in the hair follicle causing an inflammation which results in a further concentration of bacteria. This causes a break out of pimples that eventually forms a crust or a scab and may falls off spontaneously.

Causes of Itchy Scalp Pimples

Pimples on the scalp are also caused by other factors that aggravate the scalp :

• Excessive build-up of dust and plaques composed of hair product residue, oils and bacteria which accumulates in the hair root follicle.
• Sweating excessively may also lead to an increase in oil production.
• Allergic skin reactions (contact dermatitis) to hair products (hair dye allergy)
• A viral infection such chicken pox or shingles
• Skin conditions such as acne with the occurrence of cyst like formations due to blocked ducts at the site of the hair shaft.
• A deficiency in zinc intake.
• Stress can aggravate the condition as it may increase oil production.
• An irritated scalp (seborrhoeric dermatitis) can contribute to scalp pimples.
• Environmental factors such as dry and cold weather or the exposure to dust can aggravate the condition.
• A lack of hygiene where the hair is not washed frequently can cause a build up of oil resulting in pimples on the head.
• Psoriasis can cause a build up of dead skin cells which may be prone to infection.
• Eczema can aggravate the pimples on the head as it increases the shedding of normal skin cells.

Management & Treatment of Head Pimples

The condition usually subsides spontaneously if it not infected however severe cases, especially where a bacterial or fungal infection is present,  requires medical intervention.

• Improve scalp hygiene with frequent washing of the head and hair.
• Use natural or hypoallergenic shampoos as these products will reduce allergic reactions.
• It is advisable to alternate the use of two types of shampoo to prevent an oil accumulation.
• Tar shampoo and benzoyl peroxide are effective products in the management of pimples on the head but it can have a dehydrating effect if used excessively.
• If an infection occurs antibiotics is usually prescribed. Fungal infections may require antifungal hair shampoos and tablets.

It is advisable to avoid  the following :

• Scratching the scalp as it causes breaks in the skin and increasing the chance of infection
• Using hair products such such as styling gels or hair sprays.
• Hair conditioners may increase oily residue on the hair.