Perioral dermatitis on the scalp: what to know

Small red bumps, burning, itching, flaking or sensitivity on the scalp can resemble several problems, including irritation from hair products, follicle inflammation, eczema or seborrhoeic dermatitis. Perioral dermatitis is named for its usual facial distribution; scalp involvement is not the typical pattern. A clinician may ask about new shampoo, styling products, hats, sweating, dandruff and any steroid cream used near the face or hairline. A photo and examination can help separate a scalp condition from facial periorificial dermatitis. Explore [Perioral Dermatitis](/conditions/perioral-dermatitis/) and [Sensitive Skin](/symptoms/skin-sensitivity/) for related information.

Use a gentle, fragrance-free cleanser and rinse products thoroughly. Pause new gels, oils, sprays and exfoliating products until the cause is clearer, and avoid scratching or picking bumps. Do not apply a steroid or antibiotic product to the scalp without advice; treatment depends on the diagnosis. A dermatologist may consider a targeted topical medicine or, for selected cases, an oral medicine such as [Topical Antibiotic Therapy](/treatments/medical-dermatology/topical-antibiotic-therapy/) or [Oral Antibiotics For Acne](/treatments/medical-dermatology/oral-antibiotics-for-acne/).

Arrange a dermatology review if the rash is spreading, persistent, painful, draining, causing hair loss or not improving after removing an irritant. Seek prompt care for facial or eyelid swelling, fever, rapidly worsening pain, pus or a widespread blistering reaction.

Could this be folliculitis, eczema or another scalp condition rather than perioral dermatitis? Which products should I stop, and would a scalp-specific treatment be appropriate? Could any steroid use be contributing?