Scalp care is the new skincare. We’re betting you’ve heard that one before: The latest location to invest your beauty bucks is your scalp, which is why you’ve likely noticed a whole new genre of products. From serums to scrubs to masks, plenty of new offerings are helping us to take care of our scalps, because it's skin, after all.
One thing the scalp has in common with your face: It can also get clogged. In this case, we’re talking clogged hair follicles, essentially the clogged pores of the scalp world. Ahead, two dermatologists explain the causes as well as how to unclog hair follicles and rejuvenate your scalp.
What Are Clogged Hair Follicles?
Clogged hair follicles are exactly what they sound like. “The correct term is folliculitis,” says dermatologist and hair expert Jodi LoGerfo, DNP. “Folliculitis is very common and occurs when the hair follicles become inflamed, usually caused by bacteria. Sometimes they can look like small pimples around the hairs.”
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Causes of Clogged Hair Follicles
There are several reasons we can end up with clogged hair follicles. “You can get folliculitis when the hair follicles become infected with a type of bacteria,” LoGerfo says. “Often, it is Staphylococcus aureus (staph), but it can also be other types of bacteria as well as viruses or fungi. Occasionally, they can be caused by an ingrown hair. Sometimes we don’t know what the cause is.”
Clogged hair follicles can also be triggered by excess oil (sebum) or excess debris, like dead skin or hair products. “Surprisingly enough, it can also come from an excessively dry scalp with a thick dead skin layer of scalp,” says board-certified dermatologist Kseniya Kobets, MD. “When itchy red bumps or pustules (or folliculitis, a.k.a. inflammation of hair follicles) appear on the scalp, it may be related to buildup of oil or hair products (like silicone or excess oils) or may even mean a true fungal infection, which should be evaluated by a board-certified dermatologist. Folliculitis and dandruff can be exacerbated by hot temperatures and sweating, which promotes colonization of hair follicles by yeast such as Malassezia furfur (common cause of dandruff) or bacteria. Another reason for clogged pores can be hyperkeratosis (or excess dead skin) around hair follicles, which can still often be related to dandruff, psoriasis, scarring alopecia like lichen planopilaris, or even fungal infection.”
Anyone can develop the condition, though some may be more prone to it than others. “Clogged hair follicles can happen in both oily and dry scalp, but is probably more likely in more oily skin, which promotes inflammation and growth of pathogens like yeast and bacteria,” Kobets says.
Signs and Treatment
So, how can you tell if you have clogged hair follicles? There are a few main signs to look for. “The signs of folliculitis include small, inflamed bumps,” LoGerfo says. “Sometimes, the bumps can grow larger and more inflamed. They can often be pus-filled and crusty or appear as whiteheads. From time to time the skin can become very inflamed, often itching or burning. Every so often, they can become infected, requiring oral antibiotics.”
If you have clogged hair follicles, you're probably wondering how to clear them out—and you’ll want to do so, since leaving that issue unattended can lead to complications. “It is not that folliculitis is so terrible—it is often not a medical emergency,” LoGerfo says. “However, if not treated or if the folliculitis is picked, the areas can become larger and more infected. The skin can also become discolored and scarred, and there can be permanent hair loss. Sometimes the infections can become more chronic. At times, a more serious infection, called cellulitis, which can spread to the blood and lymph nodes, can occur.”
While you'll want to treat your folliculitis, you'll be relieved to know that there are several ways to do this, most of which you can do at home. Keep reading to learn our derms' nine top tips on how to unclog hair follicles for a refreshed, clear scalp.
Keep It Clean
Skipping a wash session can actually make the condition worse, while regularly sudsing up is a huge help. “Wash hair with anti-dandruff shampoo and be sure to wash your hair every day or every other day,” LoGerfo says. “If you were sweating, wash your hair/scalp as soon as possible.” She also recommends cleansing the area with antibacterial cleanser.
Step Up Your Shampoo
“For someone with a more oily scalp, scales, and clogged pores, one can start with over-the-counter Nizoral (1% ketoconazole) shampoo ($19)—or get the prescription strength 2% ketoconazole from your dermatologist,” Kobets says. “Be sure to wash only the roots of the scalp with medicated shampoo by lathering in for five minutes and washing out with another shampoo to the rest of the hair and ends, like Head & Shoulders or Selsun Blue. The reason to use only on roots is that ketoconazole or salicylic acid shampoos, although great at decreasing oil and treating yeast-causing dandruff, can be drying to the rest of the hair and may make it brittle, causing it to break off. Start with once a week. Another shampoo over the counter to use to debulk clogging and descale the scalp is Neutrogena's T/Sal shampoo ($12), which contains salicylic acid, a great keratolytic [that] breaks down dead dry skin. I often advise patients to either use these together or alternate.”
If your scalp looks red and angry, this especially applies to you. “For the inflammation, you can take an anti-inflammatory like ibuprofen,” LoGerfo says. “Use a warm compress to help soothe inflammation. You can also apply a topical steroid cream to reduce inflammation and take an OTC antihistamine, which may help soothe itching.”
Check the Label
“Try to avoid silicone or dimethicone-containing shampoos,” Kobets says. “Alternate shampoos with salicylic acid to scalp with regular shampoo to descale or exfoliate the scalp.”
“Don’t wear hats or helmets longer than necessary,” LoGerfo advises. They can trap bacteria and oil, potentially worsening the condition.
Mix It Up
“Use a variety of different shampoos—don’t use the same shampoo every day; rotate them,” LoGerfo says. Using a medicated shampoo in more severe cases can help.
“Apply antibiotic ointment to large areas and any sores that are open,” LoGerfo says.
Hands off is the best policy when it comes to unclogging hair follicles, since you don’t want to introduce more germs or trigger irritation. “Avoid constantly touching, scratching, or rubbing the scalp,” LoGerfo says, “as well as pulling or twisting at your hair.”
Stop Shaving Your Head
Putting the razor down will help ease irritation. “If you are shaving your head, use a new, clean razor each time,” LoGerfo says.
It will probably take one to two months to really see significant improvement, but you should start to see a difference within a few weeks. “If scalp symptoms of itching, pain, redness, irritation, red bumps, or pustules or scaling (dandruff) do not improve in one to two months, or if associated with progressive hair shedding, it is time to see a board-certified dermatologist,” Kobets says. “A dermatologist can prescribe several things, including ketoconazole shampoo to control oiliness and flaky scalp, a topical steroid solution to help with dandruff and itching and inflammation, or topical antibiotic gel for bacterial folliculitis.”