The highest concentration of hair follicles on your body is found on your head. Little white bumps may form around the hair follicles on the back of your scalp, and may indicate an infection known as folliculitis. According to MayoClinic.com, most cases of folliculitis will clear up within a few days, but recurring infections or infections that are deep inside the hair follicles may require medical treatment.
Folliculitis
Little white pus-filled bumps that are tender or itchy and form on the lower back of your scalp or "occipital" scalp may be a sign of folliculitis. Folliculitis on the back of your scalp is known as acne keloidalis nuchae. Folliculitis occurs when hair follicles are infected with bacteria, fungus or viruses. The infection may start with small bumps that look like whitehead pimples around one or more hair follicles on the back of your scalp. These pus-filled bumps may break open and crust over.
Causes
Hair follicles on the back of your scalp may become susceptible to infections if they are damaged during shaving. Friction from tight clothing and excessive sweating also may damage hair follicles on the back of your scalp. Skin conditions that cause inflammation, such as dermatitis or acne, may lead to folliculitis on the back of your scalp. Surgical wounds and other abrasions that damage the surface of your skin may also lead to a follicular infection.
Treatment
Superficial cases of folliculitis may clear on their own. Treatment for folliculitis on the back of your scalp may include oral or topical antibiotics that you can apply to surface of your skin. Other topical treatments may include retinoid and steroid creams or ointments. Your doctor may prescribe anti-fungal medications if you have a fungal form of folliculitis known as tinea barbae. Your health care provider may recommend surgically removing individual bumps or injecting steroids into the affected area.
Complications
Complications that occur with mild forms of folliculitis on the back of your scalp may include recurring or spreading infections and large patches or plaques of staph infection in the affected area. Complications with severe forms of folliculitis may lead to boils that become painful as they fill with pus. Severe folliculitis may destroy your hair follicles and widespread cases of severe folliculitis can lead to balding in the affected area. Folliculitis can lead to scarring and severe cases can leave thick, raised scars or patches of skin that are darker than normal.
Self-Care
You may treat mild cases of folliculitis yourself. Gently wash the back of your scalp with mild cleansers. Do not scrub the affected area. Leave the area exposed and avoid wearing constricting items like athletic helmets or collared shirts that rub against the back of your scalp. Avoid shaving that the top part of your neck. Use an electric razor or a fresh blade if you must shave this area. An over-the-counter cortisone cream may help relieve itchiness that may occur with an infection.
