have you had any luck with treatments? i am experiencing the same thing after being on accutane for 6 months, cleared up almost all of my acne but now am getting the same described painful scalp pimples. I have been off for about 4 months now, it started about a month ago and i cant put a finger as to what caused this. My girlfriend recommended using baby shampo so i started only using that. after two weeks it almost completely cleared. this last week they started to come back again. I am going to stick to the babyshampoo and will keep you updated as it seemed to work really well. i recently got a haircut ( really short) and i think that set it off again. try the babyshampoo for a couple weeks, hope this helps.

I've never had this and haven't been on accutane, but it may be worth a shot to try dandruff shampoo? Talk to your derm too.

I was on accutane for 6 months. I have been completely clear (face and body) for the most part for 2 plus years but, I have recurring scalp acne. It's large and the painful cystic type. Anyone have any success treating this? I know this is an old thread but I wanted to bump it.

I have the same problem! I took absorica (like accutane) in 2014/2015...i now get cystic painful scalp acne, that I am prone to trying to pop to relieve pressure, then it looks bad, dermatologists always diagnose it as impitigo - but I know if that is even accurate, it is only secondary to my issue. I can only use head and shoulders or dandruff shampoo, and even still, the problem isn't completely gone. After Absorica, I am gluten intolerant, and seem sensitive to dairy as well. Sometimes I wonder if eating dairy and/or gluten contribute, but I never had this issue before. I would on occasion get a zit on my scalp, but not like these! I know this sounds weird too, but another new-to-me problem is migraines that seem to be hormonal (just like my surviving acne) - so sometimes what I imagine is the sebum can no longer exit on my face, so it gets pushed to my head, and if I have scalp zits, I am more likely to get a pounding migraine. I also wonder if it is from not finishing the very last week of treatment -would that have shut down the sebum on my scalp like it did for my face? I slowly seem to be getting my cystic acne back on my face...which kind of makes me hopeful in regards to that wild and loose theory.

I hate this scalp acne and wish I could figure out a cause and solution - I really miss regular shampoos and not having to cancel my haircuts due to gross scabs on my head.

@woundedwarrior I want a better answer/reason and am curious how many people have this issue! When mine gets really bad, I use dermarest and then Medicasp tar shampoo (which seems toxic and does change my hair color). every day wash is high strength head and shoulders now... Right now, still trying to get rid of some I have had for 3 weeks.