Her teenage daughter's hair has become fat over the past few months and causes many small baskets in her hair and forehead. What could cause this change in hair – has always been on the dry side until recently – and what is the best way to treat acne on the scalp?
A: During adolescence, it is customary to have more oil on your skin, including the scalp. As a result of hormonal changes that occur during puberty, children who have never had fat or hair before they can start developing as adolescents. Typically, remedial rules can control scalp blemishes. But if the problem persists, consult your daughter's primary care provider for further evaluation and treatment.
Areas of the body affected by acne are those that have the most oil glands – also called "sebaceous glands". These include the face, forehead, chest, upper back and shoulders. Hair follicles are sensitive to acne because they are connected to oil glands.
During puberty, the hormones called "androgens" grow throughout the body. This makes the sebaceous glands grow and produce more oil or sebum. But excess oil alone does not cause acne. It is usually a combination of oil and dead skin cells, together with bacteria called Propionibacterium acnes or P. acnes. These bacteria grow on the skin all the time. However, when oil production increases during puberty, Propionibacterium acnes has a more easily available food source so that it grows and multiplies more easily.
Whiteheads, blackheads and pimples develop when oil, dead skin cells and bacteria clog the hair follicles. This combination of factors – clogged follicles or pores, sebum production and Propionibacterium acnes – is why multiple drugs are often needed to successfully treat acne.
When excess oil and acne affect hair and scalp, a good first step is to try a dandruff shampoo everywhere. These shampoos reduce the amount of oil on the scalp. Different brands have different active ingredients, such as pyritionone zinc, salicylic acid or selenium sulfide. Choosing two anti-dandruff shampoos with active ingredients that are not the same and then pausing back and forth between them offers the best results for reducing the oil on the scalp over time. For the most effective oil control, encourage your daughter to daily shampoo daily.
An antibacterial soap can also help treat the pimples on the scalp if there are not many of them or if they are limited to a small area. As the number of pimples on the scalp increases, it can be difficult to use antibacterial soaps in this way because they do not work well on large scalp surfaces.
For acne on the forehead, a wash containing benzoyl peroxide in combination with a topical retinoid such as adapalene may be useful. These drugs are available over the counter.
Contrary to popular myth, acne is not caused by eating fatty or chocolate foods, although diets with a high glycemic index may increase the risk of acne. Dirty skin is not the problem. Removing the skin that is affected by acne too hard or cleaning with hard chemicals or soaps can aggravate the problem. If your daughter bears cosmetics, it will not necessarily affect your acne, especially if you use an oil-free makeup that does not clog your pores and remove your makeup before going to bed.
If acne persists despite treatment with non-prescription products, make a schedule for your daughter to see her primary care provider. Sometimes, prescription shampoos can help reduce oil on the scalp. And the pimples that appear on the scalp can be removed using a local antibiotic with a prescription. Acne can be stubborn, so it is common for a combination of drugs to be prescribed to be treated effectively.