When most people think of acne, pimples popping up in spots like the chin, forehead, or back may immediately come to mind. Sometimes, breakouts can appear higher up on the face, like right along the hairline. Aptly named "hairline acne," these types of breakouts can be just as frustrating to tackle, treat, and prevent as those that appear on other parts of the face and body, but with the right treatment, they can be made a distant memory.
Meet the Expert
- Dr. Naissan O. Wesley MD, M.D., F.A.C.M.S. CV is a board-certified aesthetic and surgical dermatologist based in Beverly Hills, California.
- Dr. Purvisha Patel MD is a board certified dermatologist, MOHS and cosmetic surgeon, and the owner of Advanced Dermatology and Skin Cancer Associates in Memphis. She is also the founder of Visha Skincare.
We spoke with board-certified dermatologists Dr. Naissan O. Wesley MD, and Dr. Purvisha Patel MD to learn why people break out along the hairline, what do to prevent it, and which products work best at treating it.
Types of Hairline Acne
While any type of acne symptoms can, conceivably, break out along the hairline, some types are more common than others.
- Inflammatory papules: "I find it is common to see inflammatory papules, which look like pink bumps or pimples," says Wesley. "However, any type of acne can be found, including comedones, which is the medical term for blackheads and whiteheads, pustules, and cysts."
- Fungal acne: While this condition is not technically acne, it does result in breakouts due to pores clogged with a buildup of yeast. "There is a condition called Pityrosporum Folliculitis that is caused by the fungus that causes dandruff. Overgrowth of this organism on the scalp can spill down onto the forehead/hairline, behind the ears, and back," explains Patel. "It presents as small bumps on the skin and even tiny clogged pores. Using hair products with coconut oil or olive oil makes this type of acne appearing eruption worse, and acne products such as benzoyl peroxide are not as helpful to combat it."
Causes and Prevention of Hairline Acne
Hairline acne, like any other form of acne, occurs when hair follicles (or pores) become clogged with a combination of excess sebum and debris. While debris like dead skin cells or makeup that hasn’t been washed off typically lends to the formation of acne on parts of the face, hairline acne is often the result of debris from hair product buildup, sweat, and dirty fabric rubbing up against the skin, like from a hat.
- Hair products: "Breakouts around the hairline are most commonly due to hair product clogging pores, known as 'pomade acne,'" explains Wesley. "Pomade acne is typically due to buildup of oils near the hairline as a reaction to the hair product, or from clogging of the pores from the product itself." Additionally, while sodium laureth sulfate is well known by many to be a blacklisted ingredient for its drying tendencies, there are many other haircare ingredients that can lead to clogged pores: "Do not use personal hygiene products such as hair products with edible ingredients if you are acne-prone/have oily skin," explains Patel. Common pore-clogging ingredients in haircare include oils and butters, like marula oil, flaxseed oil, and avocado oil. A good rule of thumb to follow: if it tends to clog the pores on your face, don’t assume that it won’t clog the pores on or around your head, hairline included.
- Dirty fabric/materials: The items we wear around our heads, like hats, headbands, scarves, or helmets, says Wesley, can contribute to clogged pores when sweat or dead skin cells build up on them, especially as they rest close to the skin. She lists "friction or occlusion from things like headbands, hats, or helmets," among factors that can lead to clogged pores, along with "pulling the hair back too tight."
- Folliculitis: In addition to the hairline, bumps and breakouts can sometimes be found on the scalp, which may point to a condition known as folliculitis. "If the pimples are also located on the scalp and continue on to the hairline, it may be due to folliculitis, which is an inflammation or infection of the hair follicle," Wesley says. Treating your breakouts is made much easier when you know the exact cause of the symptoms, so spotting the difference between pimples and other conditions can go a long way in your skin’s recovery.
- Dirty scalp and hair: "Hairline breakouts are most commonly caused by not washing the scalp/hair as often, or using products with edible ingredients that can increase microbial growth," says Dr. Patel. The best way to clean your hairline? Wash your entire scalp and hair. "The hairline is easily skipped on face washing and is better cleaned with shampooing the hair" she adds. Additionally, anything that comes into contact with the hairline, like headbands or hats, should also be washed on a regular basis, just as you would with your pillowcases and towels.
- Poor diet: Our skin is the largest organ on the body, and the healthy habits we practice regularly can absolutely benefit the complexion, especially if you have acne. "Drink six glasses of water every day, get eight hours of sleep every day, take a multivitamin daily, take a probiotic daily, and decrease consumption of inflammatory foods such as sugar and dairy," says Patel. "These foods in the diet tend to make acne—and hairline acne—worse."
Treating hairline acne should be handled the way any treatment would—the underlying cause of the breakouts should be recognized, followed by actionable measures to rid your skin of the problem.
Isolate the cause of your breakouts
This will differ for everyone, but identifying the cause of your hairline acne will help you get rid of breakouts sooner. "If the acne is due to hair product or occlusion from hats, taking the measures previously discussed for prevention can be extremely helpful," says Wesley.
Stay on top of your skincare routine
"Engaging in a regular non-comedogenic skincare routine to increase skin cell turnover, reduce clogged pores, and decrease inflammation of existing lesions is key," says Wesley. "Some of my favorite products for this include products in the Arbonne Clear Future Line. The Deep Pore Acne Cleanser contains salicylic acid, prebiotics, sage, calendula, witch hazel, and willow bark extract to treat and exfoliate the skin gently without stripping the skin of its natural moisture."
Wash your hair
This is a fairly obvious suggestion, of course, but if you have acne around the hairline you’d like to get rid of, eliminating the scalp of product buildup is key. Clarifying shampoos are designed to do just this, and are available in a wide range of price points and formulas to get the job done, like the Neutrogena Anti-Residue Gentle Clarifying Shampoo, and Living Proof’s Perfect Hair Day Triple Detox Shampoo.
Look for antibacterial and anti-fungal ingredients
Steering clear of pore-clogging ingredients, like coconut oil, can keep pores clear, but prevention occurs when hair follicles are kept clean in the first place. "Ingredients for hairline acne should combat both bacteria and fungus as well as cleanse the skin/hair follicles," says Patel. “Sulfur, tea tree oil, and zinc pyrithione are perfect in washes and shampoos to help with hairline acne."
Clean between washes
Dry shampoo can zap unwanted oil in-between washes, but those sprays or powders can actually result in buildup over time. To keep oil at bay, try gently massaging the scalp with cool water, which will help loosen up and rinse away dirt and sweat. Can’t get your hair wet? Try an antimicrobial spray. "If washing often is not a viable option, Visha Skincare Cheek2Feet spray has witch hazel, tea tree oil and thyme oil, and is a scalp, face, and body spray that is a natural deodorant and antimicrobial spray," says Patel.
Consult a pro if stubborn acne persists
As with any skincare concern, if your hairline breakouts are persisting or getting worse, consider enlisting the help of a medical pro to rule out any underlying causes that may be contributing to your symptoms. "If needed, I would consult with a board-certified dermatologist to make sure underlying causes are being addressed and possible prescription or in-office treatments are provided if warranted," says Wesley.