Identifying and Caring For Bumps on the Scalp

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A guide to dealing with scalp folliculitis, hives, cysts, & more

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• Common Causes
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• Home Remedies
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• Seeking Medical Help
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• Expert Q&A
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• Tips

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Bumps on your scalp can be stressful and irritating. Luckily, most of these pesky bumps are easy to treat, once you figure out what’s causing them. Common causes include folliculitis, allergic reactions, and head lice. If home treatments don’t work to clear up your bumps, see a doctor for help.

Things You Should Know

• Inspect the bumps on your scalp closely. If they’re itchy and pus-filled, they might be folliculitis. If they’re irregularly shaped, they might be hives.
• Soothe an itchy, irritated scalp by mixing 1 tbsp (17 g) of salt with 2 cups (470 mL) of warm water. Wet a cloth in the mixture and press it into your scalp.
• Wash your hair with an OTC medicated shampoo to treat folliculitis. If you think your bumps are cysts or hives, switch to using hypoallergenic products.

Steps

Method 1

Method 1 of 3:

Identifying Common Causes

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1. 
   1
   Check for itchy, pus-filled bumps to identify acne or scalp folliculitis. Folliculitis is a common scalp condition that causes acne-like bumps, especially around the hairline. This condition occurs when your hair follicles get clogged up and inflamed. If you have small, itchy pimples scattered over your scalp, it may be folliculitis.

   • If your scalp itches a lot, you may develop scabs or crusting over the bumps from scratching them.
   • Scalp folliculitis can have many causes, including bacterial infection, a buildup of yeast in your scalp, or a reaction to tiny mites that live on your scalp.
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   Look for severe itching and a red rash if you suspect contact dermatitis. If you have a bad reaction to a hair product or another substance that’s come into contact with your scalp, you might develop a painful or itchy rash. Watch for bumps, swelling, and tenderness as well.

   • In some cases, you might get blisters or dry, flaking skin.
   • Rashes caused by contact dermatitis usually clear up on their own in 2-4 weeks, but your symptoms might last longer if you don’t identify and remove the cause of the irritation right away.
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   Identify hives by looking for irregular, itchy welts. If you have big, flat, irregularly shaped bumps on your scalp that come and go, you might have hives. Look out for welts that are triggered by exposure to an allergen, certain medications, or environmental triggers like stress, heat, or pressure on your skin.

   • For example, you might develop hives on your scalp after exercising or wearing a tight hat or headband.
   • Hives can be extremely itchy. They might also disappear and reappear very quickly, or change size or shape.
   • Other inflammatory reactions, like lichen planus, can also cause bumps on your scalp. Lichen planus typically causes tiny bumps, a painful red rash, and sometimes hair loss.
4. 
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   Make note of a fever and other symptoms of a viral infection. Occasionally, bumps on your scalp can be a symptom of a more widespread viral infection, such as chickenpox or shingles. If you develop a bumpy rash on your scalp, pay attention to more systemic symptoms, such as a fever, chills, muscle aches, headache, tiredness, or a general feeling of being unwell.

   • Most viral rashes clear up on their own within a few days to a couple of weeks. If your rash starts to get worse instead of better, or if you develop severe symptoms such as difficulty breathing, a high fever, or pain and stiffness in your neck, see a doctor right away.
5. 
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   Examine your hair for small, pearly nits to spot head lice. Head lice can cause small, itchy bumps or sores on your scalp and neck. If you notice these symptoms, lift the hair at the back of your neck and look at it in a mirror, or ask someone else to look at it for you. If there are tiny, pearly white or brownish ovals clinging to the hair shafts, then you likely have a lice infestation.

   • Nits are the eggs of head lice. They often become easier to see once they hatch, since empty nits are lighter in color.
   • You might also see the lice themselves, although they are typically harder to spot. They are tiny grey or tan insects, about the size of a sesame seed.
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   Watch for smooth, painless bumps to recognize cysts. Cysts are collections of keratin and lipids (fats) that sometimes form in hair follicles. If you develop a large, firm bump on your scalp, it may be a cyst. They are typically painless, although they can become painful if they get infected or inflamed.

   • Cysts are usually harmless and often go away on their own without treatment. However, it’s always a good idea to get an unusual lump or growth checked out by a doctor or dermatologist. In rare cases, a growth like this may turn out to be skin cancer.
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Method 2

Method 2 of 3:

Trying Home Remedies

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1. 
   1
   Apply a warm saltwater compress to any irritated bumps. You might be able to get some relief from folliculitis, cysts, or other inflamed bumps on your scalp by applying a warm, moist compress. Mix 1 tablespoon (17 g) of salt with 2 cups (470 mL) of warm water. Dampen a washcloth in the solution and press it to the affected area. You can do this as many times a day as you like.

   • A warm compress can also help drain a pustule or cyst.
   • As an alternative to saltwater, try mixing 1.5 cups (350 ml) of warm water with 1 tablespoon (15 mL) of vinegar. Use this mixture 3-6 times a day. The vinegar’s antimicrobial properties may help clear up any infections in your scalp.
   • Use a fresh, clean washcloth every time you apply a warm compress. Don’t use the same washcloth to clean other areas of your skin, since you might spread the infection.
2. 
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   Wash your hair after sweating or using hair products. Shampooing your hair regularly can prevent the buildup of irritating dirt, oils, sweat, and hair products. It’s especially important to wash your hair after working out, sweating, or using products that can build up in your hair, like hairsprays, gels, or waxes.

   • Scalp irritation can be a sign of either over- or under-washing your hair, so experiment with your normal shampooing schedule. You may need to wash your hair more often if you have an oily scalp, or less often if it’s dry.
3. 
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   Avoid hats or head coverings that are tight or hot. Tight, hot, or non-breathable head coverings can contribute to breakouts and irritation. If you wear a hat, headband, or headscarf, choose one that’s made of a light material and fits loosely on your head.

   • Heat or friction on your scalp can contribute to problems like folliculitis or hives.
4. 
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   Take a break from shaving if you shave your head. If you shave your head, let your hair grow out a little until your scalp has had time to heal. Shaving can irritate any active sores, pimples, or rashes, and it can also contribute to the development of ingrown hairs or razor burn.

   • If the bumps on your scalp are caused by shaving, they should clear up within a few weeks after you stop shaving.
   • You can reduce your chance of developing razor burn or folliculitis by using an electric razor and properly lubricating your hair and skin with warm water and a gentle shaving gel.
5. 
   5
   Try an OTC medicated shampoo to treat folliculitis. Folliculitis is one of the most common causes of bumps or pimples on the scalp. Depending on what’s causing your folliculitis, you might be able to clear it up with an anti-fungal or anti-dandruff shampoo. Look for shampoos containing ingredients such as ketoconazole, ciclopirox, selenium, or propylene glycol.

   • There’s some evidence that tea tree oil can help fight the bacteria or fungi that contribute to a variety of skin conditions, including folliculitis. Try a shampoo or conditioner containing tea tree oil, or add a few drops to your favorite conditioner.
   • You can also try putting an antibacterial ointment on the affected skin or washing it with an antibacterial soap, but this will only help if your folliculitis is caused by bacteria (as opposed to yeast or fungus).
   • Soothing anti-itch creams may help relieve discomfort and prevent further irritation caused by scratching.
6. 
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   Switch to hypoallergenic hair products if you have dermatitis or hives. Sometimes bumps on your scalp can be caused by an allergic reaction to a hair product. If you suspect this is the problem, try switching to gentler products that are formulated for sensitive skin.

   • Look for shampoos and other hair products that are marked “hypoallergenic,” “sensitive,” or “free and clear.” Avoid products that contain dyes and perfumes.
   • Check the ingredients list carefully for any ingredients you know you’re allergic to.
   • Aside from fragrance, some other common allergens in shampoo include cocamidopropyl betaine, methylchloroisothiazolinone, formaldehyde releasing preservatives, propylene glycol, parabens, and vitamin E.
7. 
   7
   Ask your doctor about vitamin supplements to improve your skin health. Some vitamins and supplements may help improve the health of your scalp, reducing bumps and breakouts. Ask your doctor if you might benefit from supplements such as:

   • Vitamin B
   • Zinc
   • Omega-3 fatty acids
8. 
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   Use OTC medications to treat a head lice infestation. If you think you have head lice, you may be able to get rid of them with an over-the-counter lice shampoo. These products may take several treatments over the course of 1-2 weeks to work, so read and follow the instructions carefully.

   • You can also remove many of the lice and nits from your hair using a fine-tooth nit comb. Wet your hair and add some conditioner or an oil, such as olive oil, to help lubricate the hair. The oil might also help smother and kill the lice.
   • You can buy head lice treatments and combs at most drug stores.
   • Once you get rid of the lice, the bumps and itching should clear up.
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Method 3

Method 3 of 3:

Seeking Medical Help

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1. 
   1
   See a doctor if OTC remedies aren’t helping. If you’ve been trying OTC medicines or home remedies for a few weeks without any change, call your doctor and make an appointment. They can examine your scalp and ask you questions about your symptoms, health history, and hair care habits to determine the cause of the problem.

   • Let your doctor know when the symptoms started and if you’ve experienced any recent health or lifestyle changes that might be related.
   • Give them a full list of any medications or supplements you’re taking, since this may help them pinpoint the cause of the problem. They may also need this information to figure out what medicines they can safely prescribe.
2. 
   2
   Get medical help if you see signs of an infection. Many causes of bumps on your scalp are fairly harmless, and they’ll often clear up on their own or with home care. However, sometimes a secondary infection can develop, or the bumps can be a sign of a more serious problem that needs medical attention. See your doctor as soon as possible if you notice signs of a more severe infection, such as:

   • Increasing pain, swelling, warmth, or tenderness in the affected area
   • A fever or a general feeling of being unwell
   • Pus or other discharge draining from the bumps
   • Red streaks moving away from the affected area
3. 
   3
   Take any medications according to your doctor’s instructions. Depending on what’s causing the problem, your doctor may prescribe a medication to treat the bumps on your scalp. For example, if you have folliculitis, they might recommend using antifungal or antibiotic creams or pills, or a steroid cream to help reduce inflammation. Follow your doctor’s instructions for using these medications exactly.

   • Don’t combine prescription and over-the-counter treatments unless your doctor says it’s okay.
   • If you’re taking an antibiotic or antifungal medication, finish the complete course of medication unless your doctor tells you to do otherwise. Stopping the medication too early could cause the infection to come back or get worse.
4. 
   4
   Have a dermatologist look at suspicious growths or moles. In rare cases, bumps on your scalp can be a sign of skin cancer. If you notice any unusual looking moles, changes to any moles on your scalp, sores that won’t heal, or firm bumps or growths, make an appointment with your doctor or a dermatologist. They can examine your scalp and do tests to determine if the growths are anything to worry about.

   • If your doctor suspects skin cancer, they may take a biopsy, or tissue sample, for testing. They’ll give you a local anesthetic to numb the area so you don’t feel any pain.
   • Try not to worry if you find an unusual lump or mole on your scalp. Most skin cancers are very treatable if you catch and treat them early.
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Expert Q&A

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• Question

  How are Pilar cysts removed?

  

  R. Sonia Batra, MD, MSc, MPH
  Board Certified Dermatologist

  Dr. R. Sonia Batra is a board certified Dermatologist and the Founder of Batra Dermatology based in Los Angeles, California. With over 15 years of experience, Dr. Batra specializes in lasers, medical devices, patient and public medical education, and skin cancer research. She received her Bachelor’s degree, Master’s degree in Public Health, and her Doctor of Medicine (MD) degrees from Harvard University. As a Rhodes Scholar, she earned a Master’s degree in Molecular Genetics at the University of Oxford. She completed her residency training in Dermatology at Stanford University. Dr. Batra has contributed and reviewed for the Journal of Dermatologic Surgery, the Journal of the American Academy of Dermatology, and JAMA Dermatology. She is also a co-host of CBS’ Emmy award-winning television show, The Doctors.

  

  R. Sonia Batra, MD, MSc, MPH

  Board Certified Dermatologist

  Expert Answer

  A dermatologist will remove the cyst via injection, or they'll take it out with a surgical incision.

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Tips

• If you have a severely itchy scalp, see a dermatologist. This may be a symptom of a condition that needs medical treatment, like scabies or scalp ringworm.
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• In addition to clearing up your scalp bumps, medicated shampoos can also help with other common conditions, such as an itchy scalp or dandruff caused by seborrheic dermatitis.
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